Control Issues 3/27/2015
One of the things that often happens when a person faces major illness or injury is a loss of control. The body does not work the way that it used to, sometimes temporarily, sometimes forever. When that happens, the patient often experiences feelings of fear, anger, and frustration. To compensate for the loss of control it is common for patients to try to reestablish feelings of empowerment by exercising control over every aspect of their life that they can. Sometimes the patient may want certain things done in a particular way or at a particular time or in a particular order. This can sometimes present a challenge for the caregivers and family members who are supporting the patient.
You Just Don't Understand 2/28/2015
A friend of mine who suffers from depression once made the comment that "when you have cancer people line up to help you but when you have a mental breakdown they run in the other direction." Sadly, this is true in my experience too. Many people don't get how hard it is for patients with chronic conditions that have symptoms that don't present the same way as more well known conditions or diseases like cancer or a broken bone.
That Isn't Funny...Actually It Is 10/30/2014
Recently a client of mine was transferred to a skilled nursing facility after a long hospital stay. Although her condition had improved in the hospital she was still quite weak and unable to talk much. Her recovery and rehabilitation period at the new facility was expected to be several weeks. After I made sure she was settled into the new place I emailed her adult children to let them know how she was doing. I told them I would be stopping by her home the next day to pick up some of her own toiletries, clothes and small comforts from home. I asked them if they could suggest a few specific decorations or special items at the house that I could bring to spruce up her room and make it feel more like home. The oldest son replied and suggested I pick up several framed photos of his sister, "since mom likes her best". He then immediately sent an apology message for making a joke with such a serious situation. I thanked him for the comment and encouraged him and his siblings to use humor to lighten things up as they dealt with all the issues of their mother's condition. I believe humor is an important coping mechanism.
Feeling Pretty While Sick 8/31/2014
When I was a college student, a friend of mine who majored in psychology told me that she had read a study that showed students who dressed up when they took a test had higher scores than those who wore "regular clothes". I'm not sure of the scientific validity of that study but it sounded like something with merit and I took the results to heart. When I had exams I always wore a nice dress, took time to style my hair and wore make-up and jewelry. It was quite a stark contrast to my usual college student apparel of a rumpled t-shirt and jeans. I'm not sure if it impacted my scores but I did make the dean's list a few times and I certainly felt like it helped. The idea that when you look better, you feel better and that that improves your success rate is nothing new. Most career advisers recommend dressing well as a way to express professionalism, to feel confident, and to improve your career. I believe it is important to apply the same logic when you are coping with illness.
After The Credits Roll 6/30/2014
Recently a friend of mine completed an incredibly difficult treatment plan. This course of treatment involved a full year of intensive drug therapy with brutal side effects. As the months of treatment dragged on her friends and family rallied around her to offer support and encouragement. Week by week as it wore on she focused on the day when she would have the last and final injection of the medication. When that day arrived she was flooded with messages of congratulations and hugs and high fives. Finally it was over! Weeks later when she got the news that the treatment was successful there was even more rejoicing. If a movie had been made of this story the frame would freeze on her smiling face and the credits would roll.
Life Goes On 3/27/2014
Human beings tend to be creatures of habit; we generally do things the same way most of the time. We often socialize with the same people, do the same things at our routine events and follow a typical schedule or pattern in our lives. When major illness or injury enters our lives we often put the rest of life on hold and managing the illness or injury becomes our main focus. To a certain extent this is the most logical and appropriate way to respond. However, after an initial adjustment period, most medical professionals recommend that the patient try to shift focus away from illness and return to normal life as much as possible.
The Blame Game 1/31/2014
When we got the devastating news that my husband's cancer had spread and was no longer considered curable, a lot of difficult thoughts and emotions began to surface. One of the more challenging and difficult thoughts was the idea that we could have or should have done something differently in his treatment that might have prevented this outcome. Shortly after we got the bad news I had a long conversation with a friend of mine who is also an oncologist. When I asked her how the outcome might have been affected if we had chosen a different treatment plan from the beginning she wouldn't answer. She simply said "It is a dangerous thing to play the 'what if' game." At the time her response annoyed me but now I can see the wisdom of it. This logic goes beyond questions of treatment choices but also to the cause of an illness.
Why Me? 10/31/2013
If you are dealing with a major illness you can be certain that at times you will feel like screaming "WHY ME?" Feelings of anger and resentment and general "victimhood" are natural and normal emotions for anyone coping with the stress of illness. Yet often we feel we shouldn't have, let alone express, those feelings. Often this happens because there is a general belief in our culture that having a positive attitude helps in healing. The upbeat, chipper patient who finds a way to remain positive even when things are difficult is held up as a sort of hero character in our society. While there is evidence that having a positive attitude may lead to better results for some patients, I believe this concept is a bit overblown in our society.
Getting Legal 6/30/2013
I'm often surprised by the ability of the human mind to deny things that make us uncomfortable. Every one of us knows that we are going to die someday yet the majority of people die without a will. A lawyer friend of mine recently told me that he had just visited a client in the hospital to complete a will and estate planning paperwork. This client was 87 years old and waited until he was very sick and in the hospital to create a will. I'm sure any lawyer would tell you that quickly signing papers from a hospital bed is not the best way to make these plans. The time to make these critical decisions is long before one is sick. We generally think that end of life issues are only for the old and who wants to admit they are getting old? It's natural to want to put it off. The problem is you can jeopardize your well being and make things far more difficult and expensive for your family when you wait.
A Change You Might Not Expect 3/31/2013
One of the most challenging moments for me during my husband's illness was when I had to tell him that he wasn't allowed to do something. He wanted to drive himself to a doctor's appointment but I recognized that his disease had progressed so that his concentration was affected and he could not safely drive. It was a difficult conversation for both of us, I felt awful and he was understandably upset with me. He was a grown man, not a child; I was his wife, not his mother. Yet his disease suddenly cast this completely new and uncomfortable parent/child dynamic onto our relationship.
Delivering The News 12/31/2012
Someone recently asked me for advice on the best way to tell others that they have cancer; they wanted tips on the most comforting ways they could deliver the difficult news. Unfortunately I have a lot of experience delivering "bad news". First, I had to notify friends and family that my husband had cancer. Then I had to let people know that the cancer spread and was terminal. Finally even though most people heard from others I also was the one to let some people know that my husband passed away. More than a year after his death sometimes distant colleagues have not heard the news and I've had to tell them what happened. Even in our modern era of instant mass communication it is surprising how often I had to personally give someone the difficult news.
Creating A Patient User Manual 11/28/2012
One of the most challenging parts of dealing with a major illness is that friends and acquaintances sometimes feel awkward around the patient. People feel bad because the patient is so sick and they are often afraid of saying or doing the wrong thing. This nervousness can sometimes lead to conversations with long awkward silences or prompt people to ask odd or inappropriate questions or abruptly leave. No one wants this to happen so giving visitors a bit of guidance can go a long way towards making everyone feel more comfortable.
Managing the Help 10/28/2012
It's just part of human nature: when people hear that someone they know is facing a serious illness, they want to help. But sometimes people with good intentions can create more stress for the people they're trying to support.
Advance Directives 4/6/2012
Who likes to think about what will happen if you or your loved one can no longer make medical decisions? If you say you do, you're lying. No one really wants to contemplate the idea of themselves or their loved ones being incapable of making their own decisions. It's scary and uncomfortable. Because of this discomfort, though, we can neglect making the arrangements for the kind of treatment and care we would want at the end of our lives.