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Showing posts with label Understand. Show all posts
Showing posts with label Understand. Show all posts

Thursday, November 21, 2013

Things To NEVER Say To A Person With Cancer...

I recently came across an article about things to never say to a person with cancer. There really is no guidebook about how to help a person you care about when they get sick. Its like raising children, bajillions have done it successfully but there is no book or really "right" way to do it. Well it's the same with Cancer, and when it happens to a loved one, learning how to support them cannot come from a manual and there is no "right way." There are so many things to consider; the person, the illness, the prognosis, the side effects, the treatment. Its a never ending list. I've had a lot of people ask me what to say to someone they know, or say things to me. I've been through this enough times to understand that if someone is taking the time to say anything at all to me, then they have good intentions and I hold on to that and don't let their words phase me. However, someone who is new to this may not be able too and not that it matters but here's my two cents.

On the list the first thing to never say is: #1 Everything is going to be alright. I agree because it is true that you do not know what is going to happen and you cannot guarantee that everything will be alright. As a patient, although it's comforting to hear, you're thinking in the back of your head
"You don't know that."
If you voice that to said supporter, they will usually reply with
"Stop thinking negatively."
Well there is a difference between being negative and realistic and sometimes it's comforting to talk about what scares you as a patient. The problem, it's hard for you as the supporter to hear it, what scares your loved one and what could inevitably prove to be true. As a patient I have on more than enough occasions had to be the "strong one" for my loved ones.

However, you need to realize you are not the one dealing with a life threatening situation and although this is difficult for you, you are only fighting one fear, fear of losing your loved one. The patient is fighting fear on a whole other level. Fear of; leaving you, fighting the disease that causes the fear, fighting the real negativity clouding your brain, fighting the side effects and fighting the urge to quit. So although you don't want to hear about what the patient is afraid of, you need to sit down, sit up, shut up and listen. Instead of
"Everything is going to be alright"
maybe try something like
"Yes all those things could happen, but they also could not. We're in this together and we have a strong medical team who knows what they're doing, so lets focus on what should and inevitably will go right."

This isn't on the list but this is a big one for me personally. Showing your doubts with your loved ones medical team. This is why. Everyone hates needles, if you don't, ok whatever you're weird. There have been times where I have had a nurse go to give me an iv and miss. They've had to re stick me, and there is nothing worse than your support system rolling their eyes in the corner right after the nurse misses the first vein and is gearing up for the second. The first stick hurt, the second stick will hurt too. If the nurse sees you rolling your eye's, it's going to make them more nervous that they'll fail again, and therefore more likely to mess up again. Instead of judging the nurse, accept that people are human and make mistakes. Maybe I was a really tough stick that day? Come hold my hand and breath through the pain of needle number two with me. Don't put down my medical team, these are the people responsible for saving my life and when you doubt them, I will doubt them, and then I will worry about the outcome of the treatment. I need to have faith in them. This goes for doctors, social workers, nurses, anyone who is trying to help your person through their treatment.

Now granted there are legitimate mistakes that sometimes family members need to stand up and say something, but make sure its a legitimate concern. Don't put doubt in the patients mind. If you really need to voice some concerns, do it with the doc in private. It's hard enough having faith in yourself to find the strength to fight this battle, but when you doubt the people who are spearheading your treatment, you can lose all resolve. Don't be the reason we need to waste extra energy to feel confident about what is being done to keep us alive.

#2 "I Know How You Feel." Do you? DO you know what it is like to be told "You have cancer?" Do you know what it is like to lose control of your life, not because of mistakes or choices you made but for something completely out of your control. Even if you have had a type of cancer, odds are your circumstances were completely different. Your response to medications, side effects and their severity. Chemo's used, radiations, risk factors. No two cases are exactly alike. I personally have been in the 0.01% range on more than one, heck more than 5 occasions.
"This has actually never happened before? No this can't be right, this only happens to less than 1%. etc. etc. etc."
The rule of thumb with me was if there is a 0.01% chance of a side effect, plan on me being that 0.01. For example, I couldn't metabolize methotrexate or 6MP, two very common oral chemo meds. I developed GVHD (Graph vs. Host disease [where your body rejects your bone marrow]) not on my skin like the majority of cases but internally. You will never know how another person feels about anything, because you are not that person. Whether it relates to cancer or not.

The only other thing I can say about this is, it takes away from the significance of the situation. The significance it has on the patients life. When someone tells me, they know how I feel, it makes me feel like, I'm over reacting and shouldn't be as upset about it as I am. It equates it with the feeling of
"well it happens to lots of people, so why am I significant. Why should anyone care?"
To show you care say something along the lines of
"I will never be able to understand what you are feeling, but if you want to talk about it, I am here to listen."
Or simply
"How are you holding up?"
If it's me, I usually respond with
"I'm ok,"
but I'm always grateful you asked. Even if I'm thinking,
"How the hell do you think I'm holding up? I'm pissed off and feeling like crap."
It really depends on the day.

To expand on that, the best questions I get asked are
"Do you have treatment today?" "Whats involved?"
Questions that make me feel like you not only care, but are genuinely trying to understand what I'm going through.

#3 "Try to keep a positive attitude, relax and avoid stress. It can help you heal." This one entirely depends on how its worded. With me, I constantly need people to remind me it's ok to take a break and take the time to heal. I want to jump back into work. I want to be doing something and I don't want to be missing out on life. However, I do need to take a step back and let my body heal. With that being said, when people tell me to eliminate stress from my life, I want to scream. Essentially telling someone that something in their life is stressing them out and stress causes illness means that they are doing something wrong and are to blame for their illness. Also don't tell me to stay positive, it makes me feel like I'm not allowed to feel upset for what has happened to me. If I feel like I'm not allowed to be upset, then I will shut down, shut you out and wont talk about it, therefore causing me more stress.

Someone once asked me if stress from the treatment was contributing to my hair loss and if I could just relax it wouldn't be as severe. Well, no, it was not stress, it was a side effect from the chemo. However, by saying this, I shut that person out and did not vent to them about what was indeed stressing me out anymore because they had single handedly added themselves to that list of stressors. I completely agree with the article in how to handle this. If you see a source of unease or stress, ask what you can do to help. For me, my bosses just kept reminding me jobs were waiting for me. For others it could be
"Is there anything I can do to give you some more you time?"
It doesn't suggest that there is a stressor but it gives you an opportunity to help. Also feel free to just help, because if the patient is like me, they wont ask for it. Feeling like a burden really makes this situation unbearable, because not only are we in disarray but we're causing it for others.

#4 "We can beat this." The article and I have very different interpretations on this one. For me, I like hearing it. I like knowing I'm not alone and have a strong support system. On the other hand, I can also feel like
"We, there is no we, I'm the one with the disease."
You don't want to say
"You can beat this,"
because that goes back to point number one. The way this should be worded (because its all about the wording) is
"If anyone can beat this, its you!"
That implies you have a positive attitude, you can overcome adversity in your life and it's not concrete. Cheerleaders can be annoying, I know this because I was one, so don't be a peppy cheerleader, be a cheerleader who can also be a listener.

#5 "Now Now Don't get yourself worked up." If someone said this to me I would punch them in the face, at least in my mind. You have no right to tell me I cannot get upset, or be angry, or feel pain. NO RIGHT! You are making me feel like a burden with this comment and I already feel like not only has my life been ruined but I'm affecting yours too, so thanks for confirming it. This should be an obvious one but I really do feel that common sense is a rare commodity these days. You're supposed to be a shoulder to cry on, not the nail in the emotional coffin. When you say this, you're basically saying,
"You're over reacting, its not that bad, I could handle it."
Well, then go ahead, take my place, and oh well you're at it, this is me no longer confiding in you, opening up to you and therefore causing more stress for myself by holding in my feelings. Job well done, support system. -_-

If you have nothing to say other than the above and can't manage something along the lines of
"Its completely ok to be upset, Its ok to cry, it's ok to be angry"
then you have no right to be someone's support system and you need to evaluate your lack of empathy. No seriously, you are probably the type of person who drowns puppies and puts anthrax in the mail. Ok maybe not that bad, but you get my point. If you really don't know what to say, and I get it, I've had people who have had no clue, and there's been times where I've had no clue, just give me a hug, hold my hand or send me a heart emicon. That will suffice.

#6 "Congratulations! You're done with chemo/ radiation or both." This is hard for both parties. You're excited they're done treatment. They're excited they're done treatment, but something about this is hard to hear. When I was done, I got a ton of well wishes and was grateful for every single one. People kept asking me how I was going to celebrate, when really all I wanted to do was sleep. I know I should have been just as excited, I know I should have been MORE excited but something inside me wasn't ready. Just because you're done treatment, doesn't mean you're done. I finished over two maybe three weeks ago, but I'm still recovering. I'm also still waiting for results. For me, I prefer to celebrate good results than the end of treatment. Yes I'm excited but it doesn't mean anything. Until I hear, you are cancer free, I have nothing to be excited about. This is an easy one, say something along the lines of
"How do you feel now that you're finished treatment?"
I can almost guarantee the results will be the same: anxious, nervous and relieved.

So for anyone wondering the age old question of what to say or ask, pretend you're on a date. Tread carefully. Just because it's your mother, sister, boyfriend, daughter, lover, boss, best friend, whatever, they're experiencing a life altering event and what you say can really have a strong effect. Don't be afraid to ask questions, and if you're not sure, a good place to start is,
"I understand if you don't want to talk about it, but I don't know and I'm trying to understand, is it ok if I ask...(insert question here)?"

Also, with all of this said, none of this was directed at anyone specifically. Odds are I've told you if you've said something to bother me so don't think a story is about you. You will know if it was you I was referencing, I would have told you.

One last note:

Any support is better than none at all. If you're going to support someone, never make them feel like a burden, because trust me, they're feeling it already and you validating that will only make them feel worse. Just let them know they're not alone.



Wednesday, August 28, 2013

And So It Begins.... Radiation Day 1

If you had have asked me what I expected from today when I woke up, it would be completely different from how my day ended up. (Tuesday August 27)

We had our appointment at Lankenau hospital today to just get more information on the radiation. I was scheduled to start radiation, but after our appointment at Cooper, we weren't so sure. We went into the appointment armed with a little more knowledge about the whole process and wanted to see what was different between the two hospitals and why one was better than the other.

Once in the appointment, Dr. D2 started going over everything again. It turned out, his treatment plan was almost identical to Coopers. Cooper had just gone into a lot more detail when describing (which I hate) and that's why I felt like they were completely different. Dr. D2 had a confidence about him. He knew what he needed to do and didn't want to waste time. I wouldn't be able to start with Cooper for another week. I WOULD be able to start today with him. He got up, left the room to give my mum and I a chance to decide, and my mom and I agreed, Lankenau it is. I don't want to wait any longer. Dr. D2 said it himself, my cancer was metastatic meaning it spreads and if we don't get it under control sooner than later who knows where else it will spread too and how treatable that will be.

I didn't care anymore. I like Cooper's facilities better, but I like my doctors at Lankenau better. My decision was made. Lankenau also brought up one more point that for me was a big deal. They were NOT going to do the surgery. They said there was only a 7% false positive rate that my lymph nodes were faking being cancerous. They were just going to assume they are. The robotic surgery is risky. Its dangerous. There will be scars, and I already have enough, hence why I hate bikini season.

The other thing I liked about Dr. D2, he said this one sentence which made me feel a lot better.
"You're only 25, you're young, I'm treating to cure so I'm going to be aggressive. To give you the best quality of life."
That sentence made me feel like he knows that there is no point in curing if there is no life to live after. It sounds morbid, but its true. That instilled the confidence in me to say lets just do this. I feel like I've been waiting around for Cooper and I don't have time to wait. My life is waiting for me.

I miss my friends. I miss work. GOODNESS GOLLY do I miss work. I miss my customers, my regulars, my coworkers who are my friends, I miss my bosses, even the crazy ones. I miss my gym, I miss my hometown which can honestly be insanely annoyingly small at times but I don't even care anymore. We got a FroYo place, so obviously they're moving up in the world. I want to move on and start by getting home. I'm not even upset I'm going home to the crazyness that ensues when you put your life on hold, "like crap will my car work, prob not." Dealing with OSAP and phone bills and all this stuff you try to put on hold. Its just a pain, but I don't even care. I can't even wait.

So I started radiation. I walked over with the techs and they compared me with my picture that they took on the first day I met them. (Yup, because everybody wants to be getting radiation these days, its all the rage.) I went into the room, and there was a huge machine on the table. All I keep thinking about when I think about it, is the villain from Spiderman, Dr. Octopus. The machine had these long arm like things that went around your body to take pictures (xrays before the radiation) and it was so creepy. I wasn't allowed to move. Every time the radiation beam would fire, these 5 lights which resembled Emergency Exit signs lit up with a beeping nose. My heart jumped each time.

*This is an advertisement for the machine. It's similar but not even close.

I was afraid to move even the slightest movement. I was scared at first, because how was I supposed to know how this was supposed to feel. I could feel tears welling up, and could just picture them about to roll down my cheeks but then my mindset changed. The cancer is on the left side of my pelvis and I just pictured my cancer clinging on for dear life as this machine zapped its brains out. I pictured it shrinking, disappearing. By the time I knew it, it was over. The techs came back in and told me they had to give me another tattoo. Great. That was it, it was done. I felt weird.

People keep asking me
"How do you feel?"
I don't know how I feel. I feel weird. Somethings off. I can feel the cancer, as weird as that sounds. Its on my left side and it feels like there is this cramp like sensation there. Its not tingly and its not crampy its just awkward feeling there. It feels like if I laugh too hard or loud or move the wrong way it could burst. I feel like I constantly have to pee and like I did a really intense ab workout. There's this burn sensation but not. It's just not something you can describe. I'm tired and just weirded out.

We start chemo tomorrow. Between the two, I'm probably going to be feeling like $#!%. I'm angry at the people who assumed,
"Oh this will be a piece of cake."
No, its not. It sucks and let me feel like it sucks. Stop trying to tell me not to get mad or telling me to stop pitying myself because I'm allowed to be angry and upset. I can be the most positive person in the world, because I am, I know I'm going to beat this, but I can and am allowed to hurt, and cry and be pissed the **** off sometimes.

There's nothing worse then when people try to tell you,
"Well maybe you should go do this"
, or
"maybe doing something will help."
Well you know what, maybe laying in my bed, doing nothing or reading and taking my mind off the situation will help too.
I had a person after chemo say
"Well I think it would be good for you to get out of the house, see a movie and take your mind off things."
I felt like I wanted all day to die, stop pressuring. Odds are I want to see you, I usually do, but unfortunately it has to be on my time right now. How I am going to be feeling is unpredictable, Don't take it personal.

The hardest part about dealing with any type of cancer is people not being able to relate to the situation and thinking they understand completely. YOU DONT UNDERSTAND. No matter how close you are to someone who has gone through it. I can't even relate to people that have gone through it because everyone's situation is different. Its a really lonely feeling.

The best thing people have done for me to help me get through, is to take my mind off of it. The last time I was in transplant, Twilight was just about to come out. I became obsessed, with everything Twilight. I read the books in 5 days, I went and saw the movie 13 times (I was in isolation and the only thing I was allowed to do out of the house was go to matinee movies.) It was the best distraction. Go ahead, ask me questions to understand, don't ever assume. I don't mind answering questions, it helps me to know that you're at least trying to understand. That you care. Some times, I'm not going to want to talk about it and some days I would LOVE to vent. This is where support becomes a fine line. I had a person wish me luck for radiation yesterday. After I said thanks he asked
"When will you get the results?"
haha I giggled and laughed but thought it was adorable.
"Its not a test, its a treatment so there wont be results."
I appreciated he asked, I appreciated he cared and don't expect him to know whats going on and that is 100% ok.

It sounds like I'm really ungrateful for a lot of the support I've received. I'm not, I'm so blessed. But I also know this situation is similar to a funeral... You don't know what to say. Its ok to not know what to say, whats not ok is to assume you know whats best. Aid in helping someone deal, don't tell them how to deal with their life altering situation.

As I head into the microwave Dr. Octopus machine tomorrow, I'm going to remember:
"Yes this sucks! Yes you are one unlucky SOB, but YES you can get through it. Yes you WILL get through it. Yes your life will never be the same, but YES you will have a life and you have amazing friends and family, and although you will never be ordinary and normal, you will just have to do with being extraordinary, and special."