Little people, big conversations: Mom has cancer. How to talk to your child.

Q&A with Elke Thompson
By Dr Ioanna Nixon

When Jack Wee Rabbit and Dr Betty stories were born, I made a commitment. Commitment I would bring my knowledge and experience as a doctor, and as a resilience coach, as well as my deep and broad network to talk about sensitive matters related to a child. From body acceptance, development, health and wellness self- confidence, diet, to bullying, equality and diversity, grief and illness.
It is easy to talk about the “easy”, but it is increasingly difficult to talk about things that happen in life and are more tricky to explain to a child. This week, Jack N Betty blog is meeting with our dear friend Elke Thomson to talk about a difficult, sensitive and important matter: “Mom has got cancer; how to speak to your child”.

Q: You write books for children on very sensitive topics, such as bereavement and cancer. How did you decide to write about these sensitive topics?

In April 2009 my 34-year old husband died very suddenly and unexpectedly from a heart attack whilst away on a trip with our three-year old son Alex. Our daughter was only 11 months at the time of his death. Naturally Alex asked a lot of questions about when Daddy would come back and what had happened, and when I couldn’t find a book suitable for pre-school children to help me explain death and funerals, I decided to write my own. My background is graphic design, and I had always had a strong interest in children’s books, so it wasn’t that big of a leap for me. What I hadn’t counted on was how difficult it would be to get it published though, but that is another story…
Not quite three years later, in February 2012, I found a lump in my left breast and shortly afterwards was diagnosed with an aggressive breast cancer. My kids were three and six. Again, I had to find the right words to help them understand, and there was very little on the topic I could find that used child-friendly language and imagery.

Q: having been a mom with cancer yourself, how did you approach this with your children?

I am a huge fan of honesty, and promised my children very early on that they could ask me any question, and that they would always get an honest answer. Children sense when something isn’t right, and they are actually more scared of what they don’t understand, than they are of the truth. When I got my breast cancer diagnosis, I knew I had to be honest, and really listen to my children’s fears and questions. My own children were 3 and 6 at the time of my diagnosis, and my new partner came with five daughters, aged 4 to 15.
As my friend’s sister had died from breast cancer two weeks before, I knew that my children would instantly understand the severity of the diagnosis. When we told them, the first question Alex – my 6-year-old son – asked, was: “Will you have to die now, Mummy?” My answer was honest. I said: “It’s a possibility. It could happen. But the doctors have told me that there is lots of medicine they can give me that will hopefully help me get better again.” And then I explained what would happen during chemotherapy. And when all my hair did start falling out, the kids didn’t panic, because they knew it would happen. That was a great comfort.

Q: did you even think about omitting the truth?

No. Never.
Both when my husband died and when I received my own cancer diagnosis, I knew I had to be the one to tell my children and help them understand. Children look to their grown ups for answers, and the last thing I wanted was to lose my kids’ trust or for them to blame themselves for the situation. I know parents who – with the best intentions! – try to ‘hide’ their cancer treatment from their kids for example, or who tell them that their daddy is still at work when he has in fact died. Because they don’t know what to say or how to say it, and because they want to protect their children. But unfortunately we don’t protect them by pretending that everything is hunky dory when it isn’t.
Young children will almost always blame themselves for a situation, so it is very important to use clear, precise and child-friendly language, and stress that this is not their fault.
Imagine using euphemisms such as ‘s/he has gone to sleep’ or ‘s/he has gone to a better place’ when telling a young child that their loved one has died. Both phrases may sound ‘nicer’ and potentially more child-friendly to us adults at first glance, but young children take everything very literally, so hearing that ‘s/he has gone to sleep and can never come back’, followed by ‘night, night, sleep tight, bedtime!’ can trigger panic attacks and sleep problems for example. Or imagine being three years old, and being told that ‘Daddy has gone to a better place’, which immediately triggers thoughts like ‘Maybe daddy went away because I was naughty/I didn’t eat my dinner/I didn’t tidy my room’, ‘Why couldn’t I go with him?’ or ‘When can we go visit?’ So instead of creating comfort, we actually trigger fear, panic and guilt in children. The best thing we can do as adults is to create a safe space for children to verbalise their worries, no matter how big or small, and to ask questions without fear of being told that they are ‘too small’ or ‘don’t understand’.
When I was 12 for example, my Granddad was diagnosed with incurable lung cancer, and I remember how scared I was when Mum told me we would go visit him in hospital. I thought I could ‘catch cancer’ and would have to die myself. Nobody had explained to me that cancer wasn’t contagious, and by then I was too scared to ask.

Q: where did you find inspiration, inner strength and resilience during that difficult time?

That’s a difficult question. I’m not going to lie – being diagnosed with cancer and having to undergo chemo, surgery, radiotherapy and hormone treatment, combined with the constant worry if treatment would work, was tough. I used Maggie’s Edinburgh a lot – just having a safe space to go was amazing. Everyone there – staff, volunteers, fellow patients and their families – were amazing and everybody just ‘got it’. I went to Maggie’s a lot, and received one-to-one psychological help, as well as doing group classes like thai-chi, nutrition and lots of other things, or just hanging out and having a cup of tea.
I talked openly about my fears, and I connected with fellow patients over Facebook. I remember writing a list of all the people I knew who had had breast cancer and had survived, to change my focus to a positive outcome. That really, really helped me a lot. I also tried to focus on all the things I could still do, rather than the ones I couldn’t, and used the opportunity to try out as many big earrings as possible. Humour was another great thing – I remember drawing snakes around my dark veins that had collapsed from the Epirubicin, and making little signs with ‘taste buds, this way please’, then taking selfies and posting them on social media. It wasn’t to everyone’s taste, but it really helped me. A bunch of young widows sent me ‘themed parcels’ after every round of chemo, which was just so lovely and kept me going. I think the first week I got headscarves, then earrings, then necklaces, socks when I lost most of the skin from under my feet from the Docetaxal, and finally underpants (not sure why, lol!) and chocolate medals. I also commissioned a photographer to take some nude photos of me during chemo, which was my way of taking control and celebrate my body as it was – something I struggled with. The photos are stunning, and I am so glad I did that.

Q: I am a fan of your books. As an oncologist I know how many parents try to find best way to discuss cancer with their children. How was your book received?

The feedback from oncologists, radiologists, staff and psychologists at Maggie’s Centres and families in that situation alike has been amazing. “Is it still ok to have cuddles?” helps to explain the difficult topic of breast cancer and cancer treatment easily and honestly, in age-appropriate language, whilst being clinically correct throughout. As it is our autobiographical story, we share some of our own pictures at the front and the back of the book, which help children to further identify with the characters in the book, and help all families to feel less alone. It gives hope and adults the confidence and courage to say what they need to say to help their children understand.
In April 2022 “Is it still ok to have cuddles?” was awarded the Certificate of Excellence in Literature at the 2021 Story Monsters Approved Awards in three categories: Picture Books, Family Matters and Health and Wellness.

Q: what are you working on now? Any other topics you can help us start a conversation with a child?

I am currently working on a fourth picture book, explaining incurable breast cancer to young children. The focus is very much on living with cancer, including children in the conversation and day-to-day life, and on supporting kids after loss. The important message – as it always is in my books – is: “It’s okay to be sad, but it’s okay to be happy, too.” This is my first picture book which isn’t solely based on first hand experiences, but I have worked closely with many affected families, oncologists, staff at Maggie’s Cancer Centres, as well as at our local childhood bereavement centre and a pre-bereavement hospice counsellor, who all agree that there is nothing like this currently on the market, and how important and needed it is.
As a general guide I would say always be honest, but always look for the best version of the truth. If you don’t know an answer, it’s okay to say “I don’t know. But I will try and find out, and once I know, I will let you know.” Help children understand, and really listen to their worries. Just because you think it’s unlikely or maybe a bit silly, doesn’t mean it’s not a really big concern to your child. You and I know that daddy didn’t die because your son or daughter didn’t tidy their room, but they might really think it is their fault, especially if they are very young.

Q: what advice would you give a mom dealing with cancer now?

Be open and honest with your children, but always find the best version of the truth. When Alex asked me if you could get cancer twice for example, I replied: “Yes, but I also know many people who have survived it twice.” Take time out for yourself. Ask for help. Is there someone who can walk the dog/do the shopping/do the school run/bath your kids at night? It’s okay to ask for help. Many people WANT to help, but don’t know how to. Make sure your kids know that cancer isn’t contagious, and that it’s still okay to have cuddles and kisses. Find a Maggie’s Centre near you and go. Or get in touch with other charitable organisations like Breast Cancer Now. Don’t google your symptoms – speak to your care team instead. Take one day at a time – or one hour at a time if you have to. It’s okay. The mess in the house doesn’t matter. Keep thinking ‘What if it’s all going to be okay?’, instead of ‘What if it goes wrong?’ Focus on the positives. Listen to your body. Do what’s good for your soul. Keep seeing the funny side. Talk to people.

You can find out more about Elke, her books and her journey on www.elkethompson.com

Click here to buy online and download the book “Dare to Dream Big”

Dr Ioanna Nixon is a senior oncologist in Glasgow, UK. She specialises in sarcomas and her research focuses on novel cancer therapies, quality of life and clinical innovations. She has led the Scottish Sarcoma Network since 2015 till early 2022and is the Cancer Innovation Lead for the West of Scotland. She is an honorary clinical senior lecturer at Glasgow University and an academic at Strathclyde Business School, researching on health policy and leadership. She is also an executive coach, specialising on resilience, leadership, and wellness

To contact Ioanna: Twitter, LinkedIn 

School-Bullying: what can you do to support your child to stand-up for themselves.

Dr Ioanna Nixon, MPH, PhD, FFMLM, FRCR

Consultant Oncologist and Executive Coach

Mom, can I tell you what happened at school today?

Z sprayed me in the eyes with her perfume in the library

X keeps calling me names in the playground. I am stupid he says. An idiot. Am I an idiot? He also says he might be my friend if I stop being a “nobody

In the era of millions of campaigns to promote kindness, compassion, acceptance, equality, and diversity, we all live in an anti-bullying society, right? However, bullying and harassment at schools is still happening. Which begs the question, what can we as parents do to support a child who is being bullied, and the child who the bully is. Yes, you heard me right, a bully needs to be supported, as behind these disruptive behaviours there might be underlying issues that need to be tackled.

Bullying happens when an individual or a group of people repeatedly and intentionally cause harm to another person, who is unable to avoid being targeted. Harm can take many forms: physical, emotional, mental. It has many forms, from hitting, name-calling, rumour spreading, threats and more…How one experiences bullying and harassment differs based on their age. To a child, a bully can make “being in the library”, “being in the playground”, “taking the school bus”, “walking back home from school” a deeply hurtful experience. This can have a cumulative effect, leading to negative impact on one’s self-esteem, self-worth, confidence, and sense of safety. It can profoundly affect a child’s wellbeing.

Profile of a bully

Let’s look at the anatomy of the bully’s behaviours. Why are they bullying others?

This can be due to a variety of reasons, such as:

  • The need to find a victim to gain more sense of control, power. Feel more powerful; Feel more important; feel stronger.
  • A response to how they are being treated or have been treated. Some bullies have experienced bullying in their family environment, where this is “normal” behaviour. They automatically think they can do this to others.

What can we do as parents to help our kids? Easier said than done, but here is a survival guide:

Comfort and support your child

Active listening: listen in a non-judgemental, compassionate way. Pick up on the verbal and non-verbal signs.

Powerful questioning: ask open questions. “How did that make you feel”, ”What would the ideal outcome be”, “What do you think you can do”, “How would you like me to help?”. These questions will help your child gain a sense of control, autonomy, as well as a better understanding of the situation.

Reassurance: reassure your child they are not the problem. It is not their fault they are being bullied.

Let school know

Teach your child how to deal with bullying: yes…this is not easy, but we are not meant for easy, are we? So, tell your child to:

  • Fight or flight? is often the question. Based on the profile of a bully, flight is best. Avoid the bully.
  • Manage your emotions: anger is what the bully is after. Your reaction. The impact. Don’t fall for it.
  • SPEAK UP: be assertive and address this behaviour when it happens. In the here and now. Be courageous to STAND UP FOR YOURSELF. Tell the bully to STOP.
  • Be assured you are not defined by the treatment you receive by the bully. Don’t try to find excuses for their behaviour

maybe I am an idiot, therefore I deserve being called that” ,

I am uncool, so I deserve this”.

They are the problem, not you!

  • Speak to an adult. Discuss what is happening. Don’t be afraid to share. There is nothing to be ashamed of.

As parents we can and ought to play a big role in the way we raise our children. I have head people saying: I would rather raise a bully, than a victim…Which takes us to perceptions about power, strength, balance…

We should ask ourselves: what is the example I set for my child? How do I present to the world?

Unsure how many of you watched “Wonder”. I recommend you watch this with your kids. Auggie is a 10 year old child, born with mandibulofacial dysopstosis, a rare facial deformity. He has been home-schooled, but now his parents decide to enrol him to school.  Auggie is being harassed at school by a popular child, till a teacher notices and reports this to the head of school. The head of school takes action, collects evidence and asks the bully and family to have a meeting with him. The mother of the bully defends her sons actions by stating that a child like Auggie with facial deformity should not be in that school, as her child cannot stand looking at them. Head of School suspends the bully, who, despite the mom’s stand, truly apologises to Auggie.

So, how do we, as parents want to present to the world? Are our children more “entitled” than other kids to the point we raise bullies? How do we teach them to be kind and assertive?

We are hugely accountable for how we raise our children. So, a question to you today:

How do you present to the world?

Click here to buy online and download the book “Dare to Dream Big”

Dr Ioanna Nixon is a senior oncologist in Glasgow, UK. She specialises in sarcomas and her research focuses on novel cancer therapies, quality of life and clinical innovations. She has led the Scottish Sarcoma Network since 2015 till early 2022and is the Cancer Innovation Lead for the West of Scotland. She is an honorary clinical senior lecturer at Glasgow University and an academic at Strathclyde Business School, researching on health policy and leadership. She is also an executive coach, specialising on resilience, leadership, and wellness.

To contact Ioanna: Twitter, LinkedIn 

Martial arts. Five reasons how you and your child will benefit from learning karate. 

Written by Dr Ioanna Nixon

“What is karate?, asked wee Jack.
Karate is a way of being and understanding oneself, Dr Betty said. I will tell you why…”


I thought I should write a blog about martial arts, especially karate, as this is what I am learning with my kids. I think this blog is timely as martial arts can support anyone in their personal growth through better understanding of their own self, strengths and limitations, teaching discipline, patience, and focus. All above are life skills, valuable to any child (and adult!). I have heard many thinking “I am too old to start karate!”, or “I fear my child will get hurt”.  Does this sound familiar? This blog is about myths on karate and some of the deep learning and gains any student, no matter how young or old, small, or big, tall or short, of any colour, size, and age can concur. 

Fact 1: Dojo is a place of enlightenment 
In martial arts, “do” means “the way”, or more fully, “the way to enlightenment”.  It is the way to self-realisation and understanding. If we think of a “dojo”, this is a microcosmos, a miniature cosmos, where we gain experiences. In the dojo we can make contact with our boundaries, fears, anxieties, self-beliefs, actions and reactions. 

In a dojo we get to understand quite a lot in a short period of time. This learning is hugely helpful in dealing with all that life throws on us outside the “dojo”, in the real world. School, exams, friendships, heartaches…you name it! In our work life, family life, personal life! In a dojo, a child and an adult can learn: 

No 1: Managing Conflict 
What happens with conflict? Conflict is something that many people, of any age, feel uncomfortable with. So, Conflict in a dojo is confined. Our opponents are not enemies. They are partners who help us better understand or indeed fully understand ourselves. 

No 2: Learning Discipline 
In a dojo discipline, respect, concentration are required. These skills are applicable to our daily lives. They are being practiced at the dojo, helping children to build on these skills. 

Fact 2: sensei, the master of the dojo means “the man who was born before you”.
“Sen” means “before”. “Sei” means “born”. The sense is the person who is far ahead in the way of knowledge and oath to enlightenment. They are your teacher. 

No 3: Equality and Diversity
In a dojo, there is diversity in the level of knowledge and skills. The ones that know more are obliged to transfer knowledge and support the ones who are younger in the journey. This has nothing to do with age. You may be taught by someone far younger than you! 

No 4: Perseverance and dedication, acknowledging own limitations 
In a dojo anyone is encouraged to work despite their limitations. A mentality to focus on what you can do and your strengths, allows the child to grow to the point their capabilities exceed their limitations, improve their string points to outweigh their weaknesses.

No 5: Emptying your cup
In karate and martial arts to become good at you need to “empty your cup”, unlearn what you have been taught already. This way you are open to new learning. This gradually teaches you how to keep an open mind about the world, open to feedback, and improvement. 
Can’t help but with my executive coach hat on draw some parallels with leadership! Yes, emptying your cup and be open and ready to explore new ideas is key for change, improvement, and innovation!

All above on top of the obvious: improving physical through exercising!

Through my personal journey, I find karate a fantastic opportunity for myself and my two children to learn together, explore and have fun! 
It teaches us self-defence and, some of the best talks I have heard on bullying was by our sensei, David Campbell. Karate isn’t teaching kids to be violent, become bullies and show off through fighting. It teaches them the exact opposite and helps them to understand zen and inner balance. 

To all moms and dads out there and anyone who may think they are too old about it, there is no such thing. It is all in our mind and they will be surprised at the dojo they will be the “younger” ones in their learning and very much welcomed! 

This blog was inspired by own experiences and the book “zen in the martial arts” by Joe Hyams.

Ioanna Nixon, Consultant Oncologist, executive Coach, and author.

Dr Ioanna Nixon is a senior oncologist in Glasgow, UK. She specialises in sarcomas and her research focuses on novel cancer therapies, quality of life and clinical innovations. She has led the Scottish Sarcoma Network since 2015 till early 2022and is the Cancer Innovation Lead for the West of Scotland. She is an honorary clinical senior lecturer at Glasgow University and an academic at Strathclyde Business School, researching on health policy and leadership. She is also an executive coach, specialising on resilience, leadership and wellness.

To contact Ioanna: Twitter, LinkedIn 

How I became a runner in 30 days. 

Why run? Why Exercise? Why now?

By Dr Ioanna Nixon, MPH, PhD, FRCR, FFMLM

I have been an on/off runner all my life. As a child I loved running. Running to playgrounds, beaches, school yards. 

Running however was never part of a routine. 

As a doctor I know well the importance of exercise on physical and mental health. Science suggests any moderate aerobic exercise as well as moderate intensity exercise helps us keep well, prevents diseases and makes us feel better. In people with mental illness, including depression  and on antidepressants evidence suggests they do better when exercise is part of their daily life. 

Running (and exercise in general) is leading to circulation of higher dopamine levels, as well as more dopamine receptors in our brains. Dopamine plays important role in many body functions including movement, memory pleasurable  reward and motivation, attention, behaviour and cognition. It is known as the “feel good” hormone. 

I can go on and on…

Despite all this knowledge, frequently we think of any form of exercise as a painful act, a torture. Frequently we relate it to losing weight and improving our body image. 

Running outdoors has an incredible positive impact on our psychology. 

For me, I reunited with running to fundraise for Cancer Research UK. As an oncologist, the cause speaks to my heart, so as soon as I saw the challenge, I joined without any hesitation. 

What did the challenge involve? Running 100 miles in July. 
What did the challenge involve? Running 100 miles in July. 

How did I do it? Will sound funny, but… I just did. I planned my runs and I would wake up at 5:30 am , before my kids are up, to run at least 4-5 miles every day. As soon as I laced up, that was it. I would simply do it. I kept reminding myself my metrics don’t matter, I can only improve during the process and that  I am running for a great cause. That was inspiring to fuel my body with all the energy I needed. 

Talking about energy, I ensured I slept well and ate well. Therefore, enrolling into this challenge helped me look after myself even better, and also led to developing the “runner’s bug”, as I gradually turned into a runner. 

My personal observations through this challenge are that running not only improved my aerobic capacity, my endurance, but very importantly the way I feel. 

🟢 Mood booster: I noted my mode after the run, setting the to tone of the day, was positive. I would feel more energised, enthused and prepared for whatever my day unfolds. 

🟢 Energy booster: I also felt more accomplished and with a full energy cup. Prior to establishing this routine I would feel more tired. 

🟢 Clarity: running helped me empty my head. Clear my thoughts and have more clarity. 

🟢 Connections: I joined a global community of runners! I would previously co-exist with them, but now I am actively one of them.

🟢 Inspirational: I got inspired by others taking same challenge. I got inspired by athletes. I also inspired others, including family members who from couch potato’s started running too! As I was doing it for cancer fundraising, I also raised awareness on cancer and on benefits of running. 

I completed the challenge in 22 days. 

You may wonder, what now? I continue running and I enjoy it. Along the way, I learned how to enjoy running. 

Now, this is what worked for me.

I understand running is not everyone’s cup of tea.  But moving is healing. 

Moving is an investment to our own health bank. 

So, how about exploring what might work for you? What you like. Check with your doctor and if no contraindications, start exploring. Keep a growth mindset. Think about why you are exercising. To me, although it started as a way of supporting a great cause, it is undoubtedly an act of self-love. 

There is a type of exercise for all! Any taste. Try and discover. The positives are countless. 

For me, in just 40 days I turned from an occasional runner to a regular runner. 

If I can, you can do too. 

Dr Ioanna Nixon, is an oncologist in Glasgow, UK. She specialises in sarcomas and her research is about novel treatments, and quality of life. She has led the Scottish Sarcoma Network from 2015 till early 2022 and is the Cancer Innovation Lead for West of Scotland. She is an Honorary Clinical Senior Lecturer at Glasgow University and a Visiting Professor at Strathclyde University. She is also an executive coach, specialising on leadership, resilience, and wellness.

Twitter, LinkedIn 

New kids’ book: Dare to dream Big!

Written by Dr Ioanna Nixon
Illustrations by Smaro Karipidou

What happens when a wee rabbit wants to become an astronaut? His friends think this is funny. He is only a little rabbit after all! He starts having seconds thoughts about it. Until Dr Betty shares her own story with him. And everything begins to change.

A perfect Easter gift for the little ones!
For kids and grown ups on daring to dream big!

Available at Amazon kindle edition from 👇

For printed and signed copies please get in touch!

A book about hope, motivation and empowerment. Needed in our most strange and difficult times.

How can we help our kids dream?

How can we help them take action to see their dreams through?

How can we help them see failure as learning rather than a threat, a boundary to their imagination and actions ?

A story to take us on a colourful journey of hope, on daring to dream big!

“Can I be more than just a wee Rabbit? Asked Jack

First of all, there is nothing wrong with being a wee Rabbit. It doesn’t matter what I think Jack. What matters the most is what you think”

Looking forward to your feedback! Till then, dare to dream big! The world needs it!

2022 New Year Resolution. new day, new me.

New Day, New Me. theresilienceseries

Dr Ioanna Nixon, 30.12.21

I have a dream, as 2021 is about to pass, about a new year of recovery, restoration, resilience, and reinvigoration. A year when we will wake up each day with the mindset of “new day, new me”.

It has been a difficult, challenging year. A year in a VUCA world. For those non familiar with the term VUCA, it stands for Volatility, Uncertainty, Complexity and Ambiguity. As a mom of two young boys, and an NHS Consultant oncologist I had to navigate my way through VUCA day in, day out. Have you been the same?

Life is not a straight line. Many unplanned events can happen that are hard to accept, manage and get through. So, I decided to write about how we, moms and dads out there can navigate through times of crisis. How we can be resilient when things are uncertain and ambiguous. How we can keep it all together. Dedicated to many of us who last year dealt with significant life-changing events, uncertainty and situations that challenged their resilience.

“Dear 2021,
You have been an utterly tough year. Let’s face it…you took me out of my comfort zone in every single level. You came along with many challenges to the point I am unsure where exactly to begin. …………………..

Dear 2021, a year ago I never dreamed of saying this, but THANK YOU. You have been the most transformative and restorative year in my life.

2022, I ‘ve got your back! Reminding me every day “New Day, New Me”.

Love,
Ioanna

Here is my farewell to 2021. You can tell you are missing the story, or else my challenge. I don’t think that matters. Challenges are different, however is there a way we can manage through and thrive through? Time to share with you what I discovered over the last 363 days. I figured out that to cope and balance first thing and most difficult of all is to accept and embrace everything. Accept the challenge and fully attend. To enable one to understand. Then self-empathising, before asking myself the 1-million-dollar question:

How can I help? How can I support myself get through?

We as parents frequently forget to ask that question until a challenging situation forces us to. Juggling a busy life, even at times of calm, we forget to be self-compassionate. Practicing self-compassion is central to being more resilient and enable us to be compassionate parents. It is a necessary component to foster our wellbeing and wellness.

So, in the challenging 2021 I kept reminded myself   of the following:

We all are work in progress

Be kind to myself. What does that mean in action? It means looking after yourself.

For me it meant showing the same kindness I show to my patients and my families. I started paying attention to my thoughts and deliberately change the way I spoke to myself. I became friends with my imposter and soothed the inner voice that would worry about everything or think no action is enough.

Top tips:

  • Put a routine in place of actions of self-kindness.
  • Maintain a self-care routine: make your wellness your priority
  • Speak to yourself like you would speak to someone you love. Pay attention to the words you use.

Breath. Honour your pauses. Take a pause. Give yourself permission to take a pause. To me this was a hard one. As a mom of two and a career person, pauses where not on my daily routine. Working is speedy pace, I felt at times I was running a marathon sprinting. For odd reasons, it felt right, and it was hard for me to actually give myself permission to take a break and pause. Step by step I learned how to honour my “pauses”.

Top tips:

Incorporate 5-minute breathing spaces in your daily routine. Just stop and breathe. There are several online tools and apps you can use for breathing.

Seek new knowledge and learn new skills:  cliché, but knowledge is power. It offers a whole new perspective, new ways of approaching a challenge, it generates new ideas. It can lead to opportunities! You can also learn more about how others dealt with a similar challenge in life.

In my case, I read many books. I decided to invest on the foundation to develop others and obtained a diploma in coaching. Becoming a coach helped me become more self-aware, practice active listening and improve relationships with others.

I started trying new things too. Completely new. including active listening, to myself and others and removing all the background distracting noise. Incredible things start to happen once you truly listen, understand.

Maintain a growth mindset: At times I would catch myself having a “black or white” thinking, only to remind me to challenge this. Look at the bigger picture, embrace a growth mindset and practice saying the phrase “I can’t yet”. There is so much power hiding in this little word!

To do the best for our kids we need to foster our own wellness

At the same time, I realised the incredible power of marginal gains. Baby steps and perseverance.

Top tips:

  • Try new things
  • Express your creativity
  • Keep a positive perspective

What symbolises my journey is planting a red lion flower. As I witnessed it blossoming and looked after it, I saw the reflection of my own recovery and restoration. I now feel much richer. Not in physical belongings, but in experiences, in gratitude, in self-awareness, clarity, courage, new knowledge and friendship.

Going back to my story, my baby steps took me far! Not compared to others and their journey. Compared to where I was 363 days ago. My biggest treasure is being more in the here and now. Being present in the moment. Accept I am work in progress; we all are!

Dr Ioanna Nixon, PhD, MPH, FFMLM, FRCR
Consultant Oncologist
Executive Coach (Leadership, Career Development, Resilience Coach)

September is Childhood Cancer Awareness month

An opportunity to talk openly about cancer in children and to raise awareness and find ways to support children live with and beyond cancer.

I will take you on a time machine, back in September 1999. I was just about to start as a first-year student in medical school and I accompanied my mother to a 3 day trip with children with cancer on remission and their families. This trip, through observations and interaction with children and their families set the scenes for me as a doctor. What I observed was that despite the diagnosis and having been through a difficult treatment, children are resilient. They would play and enjoy. They would communicate, engage, and dream about their future.

I remember me asking a boy what he wanted to be when he grew older. He looked at me and said “I want to marry you and become your husband”. Aside this being my first wedding proposal of serious consideration…I discovered how much will power, motivation and resilience children have. Cancer does not and should not define them.

I also remember the feeling of community How supportive families where between them. This “human centric” journey oozed empathy, compassion, and resilience and supported even stronger my decision to become an oncologist.

Undoubtedly, cancer is a devastating diagnosis for people of all walks of life and any age group. However, childhood cancer is special in the way of unique patient needs, but also the needs of the family supporting the child. In our times, treatments have evolved and according to the International Society of Paediatric Oncology(SIOP) nearly 90% of children can be cured. In addition, huge efforts are focused on the level of support for children and their families through the cancer journey, not only by the health and social care sector, but also the third sector: clinical and non-clinical networks are working in synergy to support children and families from diagnosis, treatment, and survivorship. The aim is not only to improve cure rates, but also foster quality of life and support children physically, emotionally, and mentally to grow into a healthy teenagerhood and adulthood.

This drawing was made by children with cancer during art therapy session at Hippokration Hospital, Thessaloniki, Greece.

For all I know we should not let cancer be a barrier a child’s dreams.

What can we do to help?

We can find ways to engage. An idea can be to support a cancer charity for children or organise a funding event. More importantly we should not think of cancer as a taboo. We should talk about it openly, understand more about it, about how it affects children and their families and how we can support children live with and beyond cancer.

Dr Ioanna Nixon, MPH, PhD, FFMLM, FRCR.
Consultant Clinical Oncologist
Executive Coach (leadership, inclusion/diversity and resilience).

Covid and Children

“There is in the worst of fortune the best chances for a happy change”

Euripides

Glasgow, April 2020. I am on my way to take the train to go to the hospital. As I walk I see a playground, one of the playgrounds my children used to play. I feel a sense of emptiness and sadness, along with impatience for a future where all playgrounds are full of children playing, interacting, learning and laughing together.

Undoubtedly the pandemic forced many changes upon us. As a doctor, I have seen and lived how my colleagues, teams, patients, families, the whole system coped. As a mom, I know the challenges that parents faced during lockdown and continue to now. To me, like to many, dealing with uncertainty was difficult and finding ways to reassure my young kids about present and future was a learning journey. Home schooling was also a challenge, but I accepted I can only do my best.

But…what about the children? How did they cope and how are they coping now? What are their needs? Where is the evidence? How can we talk to them about COVID-19 and the pandemic in a way they can understand? How can we support and reassure them?

So here I am, on the 5th April, one day after David’s forth birthday, seeing him building a massive lego castle. I asked him why the castle is this big and his response came as a surprise. “To hide there and stay there to protect myself “his response was. Children understand far more than we anticipate. David was insecure and scared of what was happening. I felt I needed to explain to him what was going on in a way he would understand and also in way that would not stress him and provide him with reassurance. There is no better way of doing this than a story.

So, Jack Wee Rabbit and Dr Betty were born to explain coronavirus to children. In just a few days the book had over 3000 downloads and thanks to dear friends and colleagues got translated into 10 languages. This story is proof that we all need information tailored to our kid’s needs, but also very importantly that at times of uncertainty people want to help each other and do the best they can. Like all my friends who without questioning translated the book and I am grateful to it.

The book helped us a lot, however I still had many questions on COVID-19 by my kids. “Will I catch COVID-19 and get very sick?”, “Will you get sick mom?”, “Will the pandemic ever stop and when?”, “What is vulnerable?” are only a few of these. Does this sound familiar?

Adding to what Jack and Dr Betty story tells us, studies confirm that kids need information on coronavirus and the pandemic. From what children reported in a survey conducted by Edgehill University, they wish to receive information from their parents, school and also from  TV(1). Children  also need honest discussion about coronavirus as they reported feeling the information they receive  is underplaying the pandemic and the impact of coronavirus on people. Research also revealed that 50% of parents worry that lockdown will have a negative impact on their children’s live over the next year(2). Children reported feeling lonely, not getting enough satisfied with their lives and not having control.

Reality is that children will continue to receive information on COVID-19 pandemic. It is difficult for them to understand, adapt to all the changes and also understand the changes to the rules. It is also difficult for them to understand why adults might be anxious and stressed too.

So, what can we do as parents to support our children during this transition in the post-lockdown period?

Help children to manage the information they hear: allow them time and space to express how they feel about it. Offer the opportunity to ask questions and share what is in their minds. Listen with fascination and be in the moment with them. Welcome any ques.

Filter the information and be in charge of how your child makes the interpretation of these.

Encourage their questions and answer to these with honesty and clarity. This needs to be tailored to their developmental stage.

Feel comfortable to say “I don’t know”. At times of uncertainty it is expected that there are questions we can’t answer and this is ok. We can be tempted to make promises that everything will be ok, however this is a great opportunity to teach them how to cope with uncertainty and build on their resilience.

Accept your own stress and anxiety: it is important that we are self – aware and understand our own worry and anxiety during this time.

Provide them with reassurance: children get worried about illness and death and may think this will happen to them. Discuss with them their worry and reassure them that very few children get sick.

Empower children: Offer them control by discussing what we can all do to stay safe. Re iterate the importance of hand washing- Jack and Dr Betty song is a good family singing while hand washing for 20 seconds.

Be present for them and open to all their questions.

It is ok for them and for us to feel anxious, worried, insecure. It is ok. We are learning during this time and we can use this as a unique opportunity to teach them how to cope and become more resilient.

Because if as Euripides said “There is in the worst of fortune the best chances for a happy change”, we can use this knowledge and learning to develop a better future for everyone, more importantly the children.

Dr Ioanna Nixon, Oncologist and Career, Performance, Leadership and Resilience Coach

1. Children’s information about COVID19
2. Life on hold: Children’s wellbeing and COVID19

How to tell your child you are proud of them: the 3 magic words

A graduation, a pic-nic, and another story of joy hiding in the smallest things.

Hello again! When I was a child, I remember how important it was to know my family was proud of me. It was important they celebrated my efforts, achievements and that they were also there for me when I experienced failure. As a mom of two boys, aged 10 and 5, I try to always remind myself of how important it is to show my own kids how proud I am for them. Show it in a way they understand and for all the things that matter to them. The things they feel proud of and also the things they feel they could do better at or experiencing as failure.

Here is a common story. 9 years ago, when George, my eldest, was 1 year old, he made his first little baby steps. His first unsteady little steps!  I very vividly remember how I felt on that day. He was trying and falling and keep trying till he actually made his first steps. He was so happy I was so happy and of course a wee celebration in the house followed with hundreds of pictures. No exaggeration here, literally hundreds. The same thing happened when he managed to hold his spoon and started eating without help. Once again, hundreds of pictures and a wee celebration of this milestone. Same thing when he said his first word, counted to three, learned to read his first word. Does this sound familiar? Have you also been there? Since then there have been many milestones in his development that we celebrated, showing how proud we are for his efforts and achievements.

What about the daily achievements?  How do we acknowledge these and show our child we are proud of them? More importantly, what about what the child experiences as a failure, which is probably the most important time we need to express how proud we are of them? As a working mom, juggling a career in medicine, I know how difficult it can be and how much guilt we sometimes feel when we are not present when something important happens. Or when we are too busy at work or too tired. I know this for fact, as I am also walking the walk. First thing first, get rid of any guilt and let us explore TOGETHER how we can praise our children for the little and big achievements and give them pride in failures. Do this in a way they understand. In a way that matters to them and is meaningful to them.

Research suggests although we are all proud of our kids, the way we are communicating this is not always good enough. Research also highlights how important it is to praise our children to support their development at all levels.

It is important we express this and communicate it effectively to motivate them, teach them how to be proud of themselves and how to accept themselves. Teach them how to learn from success and failure, turning both into steps for future development. Descriptive praise, encouraging efforts and using rewards are a few ways of doing this effectively. Using all above is the recipe to behavioural change:

  • Descriptive praise: tell your child what it is they did that made you proud of them. Explain to them why rather than simply saying “I am proud of you”.
  • Encouraging efforts: acknowledge the effort and praise it. “I see how much effort you put into your homework today. Well done!”, or “tell me how you made this drawing. I like the colors and the theme. How did you make these choices?”
  • Rewards: using treats tailored to your child’s likes is a fantastic way of telling them they did a good job!

Combining all three above works magic! When we praise, encourage and offer reward for a certain behaviour it is more likely our child will adapt this behaviour. The precondition is we need to notice positive behaviours in the first instance. Our brain is wired to notice negative behaviours more than the positive ones. As parents we should be aware of this and make deliberate effort to notice, praise, encourage and reward positive behaviours.

Words carry a lot of meaning and weight. Our parenting magic words are:

Love:

I love you: I know I have not revealed a secret, rather than pointing the obvious. However, saying “I love you” is vital. It creates the psychological safety for the children to develop, become self-confident and self-appreciative and thrive.

Believe

“I believe in you”

Support and Encourage

“Just Go for it!”

Interested and Curious

“Tell me how you made this”, “Show me how you did this”

Be Proud

“I am proud of you”: tell your child you are proud of them. Important we express this in a way that our child understands it. Equally important we validate what we say. We explain why we are proud. Every accomplishment, small or big deserves a celebration and acknowledgment of the effort your child put into that accomplishment. Rituals are a very good way to do this. Tailored to the child’s interests and likes, a special treat to celebrate. A note saying “you did this!”. Very important to express how proud we are when our child experiences failure. Don’t compare the child to another child or sibling.  If the child does this themselves explain we are all unique and different. Explore with them what it is they feel they could have done better and what they can do to improve.

Walk beside you

“I am here, no matter what”. I walk with you, beside you. Not ahead or behind. Beside you. I hold your hand when you need me to. I am letting you explore, be curious about the world and sharing my knowledge with you. I am here for you, see you grow and become your unique self.

A kind reminder this is not at all about us moms and dads. Very importantly remember we are all perfectly imperfect. There is no perfect child or perfect mom or dad.

It was this Friday my youngest son graduated from kindergarten. Because of the pandemic we could not attend the ceremony. However, he returned home so happy and proud wearing a graduation hat, holding a little paper bag with treats he would not share with anyone else in the world, labelled as “you did it!”. The school, despite the barriers and obstacles made it so memorable for the kids. Using love, care and creativity!

The weather was good, and we had a celebration picnic in our local park to make it memorable. Lots of colourful baloons too.

Regardless the weather, a cuddle, a smile and our parental magic words: I love you, I am here and proud of you.

Dr Ioanna Nixon, Oncologist and Career, Performance, Leadership and Resilience Coach

Cuddles, Movies, some COVID19 education and the secret of the art of living

Last Sunday was not a very good Sunday. My 5 year old son, David was not very well. He woke up with his cheeks looking red and hot and had a temperature of 39. Not great, especially at times of COVID. So, our Sunday was all about making him feel a bit better and organising COVID PCR tests. Explaining how the COVID testing is done didn’t go down very well. It brought a lot of crying and begging “not to have it”. It also brought up a number of questions about coronavirus you would not expect a 5 year old to ask. And the following dialog between a 5 year old and a 10 year old.

David (5 year old): what if I have covid?
George (10 year old): you will be fine. Kids are find and just carriers. Unless you have the Indian variant.
David: What is Indian Varia? Do I have varia?
George: Variant, I said variant. This is common type of that virus.
David: will I be sick? Will COVID ever go away?
George: it probably won’t.
David: won’t it?!!!!!!!! IT WON’T GO AWAY???? MOM!!!! George is saying COVID will never go away.
George: I didn’t say that. It will probably become like the flu.

The above conversation happened in seconds. It clearly indicated that my kids, like all kids, understand far more than I thought and also make their own interpretation about things Time for clarity and a covid chat…We chatted again about what the virus is and why we still need to be vigilant: keeping a 2 m distance, wear mask and hand washing. We also read again Jack Wee Rabbit is scared of COVID 19. Dr Betty can help book, which is free to download from our website and translated in many languages. Luckily it did help again.

When a 5 year old is under the weather they need love and care. In fact, when anyone is under the weather – even Despicable Me- most likely what they need is love and care. David is no exception, so Sunday was a cuddly day and also a movie day. Amongst other movies we watched SOUL, by Disney and Pixar. I can’t recommend it strongly enough, especially during our difficult times, However, I will not spoil anything by talking you through the story, which is amazing! What I will share though is the amazing impact it had on a wee 5 y old unwell boy and his two exhausted parents. SOUL was a reminder that living is an art. The secret in life is simple,   somewhat as simple as just enjoying “being” and find meaning at “doing”. With all the ups and downs.

With all the ups and downs David slept. Monday woke up and was a different, brand new day.

Dr Ioanna Nixon, Oncologist, Author and Executive Coach at Health Empower