Hi Angie

Alex suffered in similar ways and one day he realised that he hadn't had a down day for a week. And then it was a whole month that he went without a bad day. The bad days get further and further apart but you may not realise it. Maybe a journal or blog that you write a note about your physical and mental status every day so that you can see your progress?

It is not just oral cancer survivors that experience this - it is typical for those who face a life changing event. Typically, it hits 6-12 weeks later when you are no longer actively fighting the disease by trekking to radiation every day, have no doctor to talk to every week, and your carer has stopped making you the centre of attention and has gone back to reorganising his or her own life(and I mean this in a nice way). You feel "cut loose" and it may even hit you how close you came... You realise that you need to make plans beyond today. This can be an overwhelming prospect.

On top of this there are physical issues - hormones all over the place, fatigue, weight loss, crap nutrition which all contribute. Your immune system will still be recovering and all your energy will be going into rebuilding, leaving little energy for your mental health. Even a little cold may cause a "woe is me" feeling.

But it gets better. The anxiety may never go away completely, but episodes will be further and further apart and less intense as time goes on.

The shaking and teeth chattering sounds like a stress reaction. Alex goes all "two year old" on me which starts as we drive into the shadow of the hospital (eg told the doctor "no" when they tried to look down his throat - what was he there for?). I have told our cancer co-ordinator that Alex is suffering post traumatic stress and cannot sit in the waiting room with a dozen other head and neck patients - many of whom haven't had the same positive outcome Alex has. How barbaric!!!

But back to your reaction - very common to have the reaction after the event as the adrenalin leaves you. There are medications you can take or you can ride it out depending how awful it is for you. Also plan to sit down somewhere nice afterwards to let it pass. Breathing exercises maybe? Just knowing this reaction might happen and that it is to be expected, may be enough for you to manage it? If not, find a counsellor who will help you with coping techniques. Hopefully the reaction will lessen with time as you become more used to your appointments.