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Information for Patients and Caregivers


A Nurse's Reflection/Survival Strategies

As a nurse, I have had the pleasure of working with patients and families who have received diagnoses that have sent them down paths they were ill prepared to travel. With discharge plans in hand, patients and families would begin their journey. I often wondered how things turned out for these people and naively believed that everyone was returning to life as usual.

My journey into the medical community as a family member began when my mother was diagnosed with breast cancer. My father was diagnosed with prostate cancer within a year of mother's diagnosis and we were catapulted into a world of discovery.

When mother was diagnosed with breast cancer, I felt as if I had stepped off the edge of the earth. Suddenly lost, I was unsure of who to ask questions and angry that "they" (the doctors) had somehow missed finding the cancer. Through one episode of recurrence, two bouts of chemotherapy, and one series of radiation therapy, mother remained the Rock of Gibraltar.

Father's diagnosis of prostate cancer was somehow easier to take. A radical surgery procedure was sufficient to remove the invading prostatic cancer with no chemotherapy or radiation therapy needed. This time, questions were easier to ask of the doctors and mother would accompany dad to appointments with lists of questions in hand. I learned much of what I know about cancer and its effect on families through these experiences with my parents.

I await the definitive diagnosis for a nodule discovered in my left breast on routine mammography. I find myself amazingly calm and unafraid. This lack of fear does not stem from the assumption that the nodule will be benign. Instead, it comes from observing the responses and strategies used by past patients, families, and my parents which have been most useful for me today.

Fortunately, my parents are cancer survivors. They continue to seek yearly health care advice from trusted health care providers. Cancer groups and family members provide systems of support. The greatest source of strength for each has been the other, as I watched them move through difficult times. An ability to view the world in positive terms and the presence of spirituality in their processes has allowed them to remain optimistic. It has been through observing my parents' responses to cancer that I learned valuable lessons in living with the disease.

Strategies I have found useful include:

  • Be in control of your own health care
  • Develop support systems that work for you
  • Reframe your thinking in positive ways
  • Strengthen yourself through spirituality

Be in control of your own health care

Be in control of your own health care. Don't be afraid to ask questions. Instead, ask many questions! Write down questions before you go into an office or treatment center so you don't forget what you want to ask. Take notes about what you are being told, ask how to spell words that you are unsure of, and ask for unclear thoughts to be clarified for you.

Request second opinions. Even if the second opinion gives you the same information as the first diagnosis, there is nothing wrong with being cautious. When you contact an office to request copies of your records or diagnostic films, ask if the office requires you to fill out any special forms or to obtain signatures. Be clear about what you need! Find out from your second opinion provider what information they specifically need before you see them. Relay these needs to your primary provider so a complete package of records can be prepared for you.

Insurance constraints may limit the scope of providers from which you can seek a second opinion. Clarify this with your insurer before you find yourself responsible for expensive medical bills.

Actively search for information from your local chapter of the American Cancer Society, the library, your health care provider, a support group, and various Internet sources.

Develop support systems that work for you

Develop support systems that work for you. Whether you attend formal support groups or rely on the help of family and friends, develop contacts with people you can count on when the going gets tough. The support systems should be with those people you feel comfortable calling. Support groups with members who have similar diagnoses can provide a wealth of knowledge. Network with others in similar situations and share ideas.

Reframe your thinking in positive ways

Reframing means the ability to place a situation in a different, more positive light. For example, if you require the assistance of someone to drive you to and from appointments and you feel this task is burdensome for them, think of the positives that occur during the interaction. The time spent with others is an opportunity to catch up on old times and share new ideas. Viewing a class as half-full rather than half-empty is an example of reframing.

Sometimes it is necessary to ask others for help with chores or personal assistance. It is not uncommon to think of asking for this assistance as intruding on someone else's time. Reframing in this example would be to view this as an opportunity to slow down, to "smell the roses," and to take the time to help someone in need. Caregivers have reported feeling fulfillment in assisting others. Taking the time to share and care with someone can be the most positive experience of a lifetime.

Strengthen yourself through spirituality

Spirituality is the feeling of connectedness felt with a higher power. The knowledge that even in the darkest hour you are not alone is spirituality. Feeling comfort in a cool breeze passing over your face is spirituality. Holding someone in your arms as they take their last breath is spirituality. Washing the remnants of a hard spent day from a brow furrowed by the passage of time is spirituality. Sharing time or money or food with no expectation of a gift in return is spirituality. Random acts of kindness and the "little things" are in essence random acts of spirituality.

Taking control of your own health care, developing support systems, framing systems in positive terms, and spirituality will help to strengthen even the weakest resolve. Developing these strategies into a way of life takes time, work, and commitment. The benefits gained through utilizing these strategies outweigh the labor involved and will provide a framework of strength that will endure the most difficult times.

(Submitted by Susan Hoppough, MSNc, RN)

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Last modified on 01/28/2004