Archives for category: Feelings

All of this kindness is giving me a headache!

June 7, 2012 //

I have a bit of a headache this morning. Yes, I had the wonderful news yesterday about my genetic test results. I really was quite elated. I’m still very happy about it deep down, but at the moment I am feeling a bit numb. I told a lot of parents about my cancer and a couple of teens. One of them is a girl I just started seeing again for counseling after a couple of year gap. Her mom just finished a really aggressive experimental treatment protocol for cancer (not breast). Ugh. This is not the kind of thing I wanted to have to tell her. The conversation went relatively well and we will see how it goes.

Yesterday, one of the parents I told got pretty teary eyed and another gave me a hug. I also received an email from a physician I know who works at Swedish who found out through the grapevine, had questions, offered help, and upon finding out who my physicians were, told me that he knew them and that I was in “excellent hands.”

Then there’s the constant support of friends and family who have been there for me through this as well as other ups and downs in my life. This last 12 months has been really the most challenging time in my life. (The non-cancer reasons will have to wait for coverage in a separate blog, but I’ll give you a hint. Parenting + teen girl.) Because of this, I do have a concern that comes up from time to time that I am really getting more from family and friends than I am giving back. But it is a manageable concern and I know that it is part of life and how we support one another. It’s not always equal.

So with all of this wonderful life affirming kindness, why the headache this morning? Well it’s not like I don’t see kindness every day because I really do. I think it’s in part because it underscores the gravity of my situation. Another part has to do with being a person who is more comfortable as a caretaker. Although I do like to be taken care of at times, I don’t like it to be my primary role. Finally, as a psychologist, we are trained to be caretakers and there are actual ethnics and laws around keeping our relationships with clients and their families professional. Legally, we are to required to avoid “multiple relationships”. In other words, the only relationship I am to have is to be their psychologist. I can’t be a friend (though I certainly know families with whom I would love to be friends with under different circumstances), I can’t do other business with clients (though I admit I bought Cub Scout popcorn from one of my former clients–he was right in front of the grocery store with a big smile on his face, it was for charity, he’s not roofing my house, I think I’ll be able to keep my license), etc. But because I help kids and their parents with issues close to the heart, the relationships I have, though professional, can also be very close. It’s a unique relationship, it can be an intimate relationship, but one without total reciprocity. The closest analogy is being a parent. As a parent, we have the responsibility to do the lion’s share of giving.

So, although I don’t want you to read this and think that I am fearing that by sharing my cancer status with families that I am being unethical, it is an awkward and uncomfortable experience. And there are a couple of kids who I think may have a particularly hard time with this. One of them I only see every 4-6 weeks, so she may be able to stay out of the loop. But the other kid I see on a weekly basis. I had my monthly consultation group with my psychologist friends/colleagues and I decided to hold off telling him unless I have to and certainly not until I have more information about my treatment plan.

My head is starting to feel a bit better. Thank you, Blog.

Tags Breast Cancer, Coping with cancer

Categories Best of Blog, Feelings

Excellent news–Some parts I can keep!

June 6, 2012 //

I’m so relieved. My genetic test results came back normal. Hooray! For my own self-centered reasons, I am happy because this means that removal of my ovaries will not be recommended. The genes (BRCA 1 & 2) put women at a 40% risk of ovarian cancer, in addition to the increased risk of breast cancer. Since ovarian cancer is very difficult to detect until it is fairly advanced, the 40% odds are kind of sobering. I’m relieved that my ovaries are “off the table” surgery wise.

The other reason I am relieved is that this means that family members, especially the young women in the family like my daughter and nieces do not need testing.

Hooray!

Categories Facts, Feelings

My popularity ratings are holding steady

June 6, 2012 //

I’ve had a private practice since 2003. I am used to having a fair number of phone calls to make about scheduling appointments. Right now, the number of voice mails I have received has been reduced substantially. This is because on my voice mail greeting, I let people know that I will not be able to schedule any new patients until the fall of 2012. So, the phone calls are much more manageable and it saves me from having to explain my situation to people who would rather see if they can find someone with more immediate openings.

However, the former popularity of my office phone has transferred to my cell phone. Now I am inundated with calls for appointments for me with the physicians at Swedish Cancer Institute, test results, etc.

In this disruptive time, it is oddly comforting to identify some pattern of equilibrium in my life, even if it’s silly.

Categories Feelings

Some abnormal growth is beautiful.

June 5, 2012 //

This picture is a reminder that not everything that is abnormal is deadly. Normal is just a mathematical term to mean “average”. This is a picture of a tulip from last year, which bloomed with a little extra tulip on the right. It was a beauty and it re-bloomed this year, but without the floral side car.

I remember in grad school, my professor, David Galinsky told us that some things were “deviant but not pathological”. I know that my cancer does not fall into that category but for whatever reason, it is nice to remind myself of this fact. So to all you not pathological deviants out there, I salute you!

Categories Feelings

Scalpel-The only way to fly

June 5, 2012 //

Okay, my surgery has been rescheduled for 6/27. (No medical problems, just logistics.) Surgery is at 9 am with a check in time of 6 am! Three hours! It’s not international travel, people!

John says they are just making sure I am too tired to accidentally eat anything on the day of surgery. Maybe he’s right. I say that they are making me wake up at an ungodly hour only to inconvenience me in their silly quest to save my life! (I kid, for those of you who do not entirely get my humor.)

Categories Facts, Feelings

No cute cat pictures today-Stream of consciousness

June 4, 2012 //

Well, back to work today after the weekend. I had a full schedule. I’ve also had to let more folks know about my health status as it is wreaking havoc with my work schedule. I see about 150 patients a year. I primarily do testing these days and a little counseling. This allows me to come home earlier in the day since kids I counsel need to come during the after school hours whereas I only need to see a kid a couple of times for testing so it is easier for them to miss some school. I have 16 assessments scheduled between now and the end of the summer. I would have more but I stopped scheduling people once I diagnosed. I usually have about a 6-10 week wait for an initial appointment but now I have a voice mail that says that there is at least a 4 month wait for an initial appointment. That’s cut down on the phone messages considerably as has telling my main referral sources that I have a four month wait. There are some folks who still want to see me because I was strongly recommended. While it is mostly flattering, I do feel a little bit of pressure to live up to “the hype,” especially given the wait. “You mean, I waited 4 months for this?” Okay, this doesn’t keep me up at nights but I do think about it a little.

Anyway, between the 16 kids I am assessing, the 8 ongoing counseling kids, and the parents of kids I’ve seen in the past that will contact me over the summer to reconnect, I’ll probably end up needing to discuss my health with about 30 families. A couple of the kids I see already have moms with serious medical conditions. I’m not sure how mine will fit into the mix. Sometimes, things I think will bother kids don’t and other times I am surprised by something I thought wasn’t a big deal, which throws a kid for a loop. In any event, counseling can be a very special relationship. I will try my best so that kids and parents don’t feel like they need to worry about me but there are limits to what I can do. I will focus on being as upbeat and optimistic as I can be. I am also hopeful that parents will model a positive attitude. I know that health issues scare a lot of people and sometimes people who are scared unintentionally spread their fear like a contagion. So far, most families have responded in very positive and hopeful ways. I’ve gotten a couple of responses that have raised my eyebrows. Fortunately, I feel pretty solid emotionally so I felt bemusement rather than distress.

On another note, I find myself waking up each morning thinking “I have cancer” not exactly in a distressed way (though these are not pleasant thoughts) but similar to the way I’ve experienced other changes in my status such as the first few weeks of being married (“I’m a wife”) or of being a mom (“I’m a parent”). I’ll keep the marriage and the kid but I hope to soon be able to get rid of the cancer.

Categories Feelings

Probabilities

June 2, 2012 //

As a psychologist, especially one who was a researcher for many years, I know a lot about probability. The efficacy of our treatments are assessed using probabilities. For example, in a study assessing the efficacy of a treatment for depression, the question for the treatment group would be, “How probable is it that improvements in the group that got the depression treatment were due to chance rather than from the treatment itself?” If the probability is low, less than 5%, it is taken as positive support for the treatment. I am oversimplifying here so that you don’t pass out with boredom before I get to my point.

In my clinical work, I work to select strategies that maximize the probability that a child will be helped. There are no absolutes. We can’t control other people, we can just look for the avenues where we have the best chance of influence and focus our efforts there. I also can make predictions about long-term outcomes for kids with particular issues but I can’t tell parents absolutely what the future reality will be. For example, I can tell a parent if he/she has ADHD, there’s nearly a 50% chance that any child he/she will have will also have ADHD. I can also tell them that if a child has ADHD, there’s about a 66% chance that he/she will have some other diagnosable condition. I can tell a parent of a child whom I’ve diagnosed with ADHD what the best practices are for treatment, for example that stimulant medication has an 80% efficacy rate. (I know that ADHD meds make a lot of people uncomfortable but if you wouldn’t mind, please don’t use my blog as a forum for expressing your views on this subject.) I can give a list of possibilities and sometimes I can even make pretty good predictions based on information I already have about the child but I can’t know for sure. In talking to parents about these numbers, I have to balance a tight rope of providing them with enough information so that they can make informed decisions, convey the information in a way that will encourage relatively quick action, but not scare them silly. This is a different balance for each parent, which can make it difficult if I am talking to two parents who have very different coping styles. It also depends on the child’s particular situation. Some situations are more dire and urgent than others. Oops, I’m blathering on and on again. Back to the main point.

So I know a lot about numbers, predicting, identifying risk and protective factors, treatment effects, etc. I also know that the numbers can be extremely useful but there is a balance between keeping myself knowledgeable and borrowing trouble. I will be getting my genetics testing results back in a couple of weeks. I know that my chances of having any of the genes is low based on probabilities for the general population as well as those based on my family history. I know the probability is low but I can’t tell you the exact number. And I’m not going to look it up in my notes from the genetics counselor. I have learned the hard way in my life that worrying about something I can’t do anything about is a recipe for crazy. When the time is right to get lots of information, you know I’m going to get lots and make the best decision I can based on the information that is available. So until I know what the findings of the test are and can develop a plan for dealing with it, I’m going to fight the urge to spin my wheels on the Internet or keep myself up at night worrying. Obviously, this will be harder as I get closer to the two week mark, but I’m going to do my best.

Wish me luck in keeping this balance between information-collection and sanity preservation.

Categories Facts, Feelings

Protected: Awww and Aaaah

June 2, 2012 //

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Categories Feelings

Absurd exercise in self examination

June 1, 2012 //

So my phone alarm went off this morning as it does every month to remind me to do something very important. Is it to pay the mortgage or the rent on my office? No silly, it’s to remind me that it was time for my monthly breast self-exam. When the alarm went off, I laughed a little. What was I going to find that three mammograms, two ultrasounds, a biopsy, and an MRI would have missed? Then I thought, “What the heck? I’ll just do it and keep up the habit. Plus, lefty has not gotten nearly the attention that righty has gotten.” So I did my exam and not surprisingly I felt nothing, even in the area that has a known tumor.

So ladies, you will soon tire of hearing me say this if you haven’t already, be sure to get regular mammograms. Yes, they are awkward, yes, they hurt, yes, you may feel that you are the star of some really weird fetish film. Plus, almost all of us have given birth by the time we start mammograms. That’s a lifetime of awkward physical exams for each kid. Finally, for the 12% of you that will some day get breast cancer, all that boob squishing will likely save your life.

Yes, I know I turning into a zealot. I’m going to dye my hair pink, wear only pink clothing, and get a pink ribbon tattooed on my right forearm. Feel free to dodge my calls if this happens but don’t forget to get your mammograms.

Categories Facts, Feelings

Lots of kindness

May 31, 2012 //

Although my husband may disagree in matters related to my attitude toward his contributions to housekeeping, I am a pretty positive person. I believe in the inherent value of people even if they do “bad things” or worse, even if they annoy me. Even with my above average rosy view of humanity, I am absolutely blown away by the kindness I have received regarding my cancer. There is at least one person praying for me (a chaplain at St. James’ Cathedral) who has never met me. My friends and relatives have been beyond kind and helpful. The various technicians and nurses at Swedish and their partner health care offices tend to my comfort, ask me for the names of my doctors, and tell me that I have an “excellent team” caring for me.

I sure don’t like being seriously ill but this is pretty sweet. No wonder Huck Finn (or was it Tom Sawyer) faked his own death so he could hear all of the nice things that people said about them. No wonder people have trouble with malingering or Munchausen’s by proxy. All of this attention could be addictive to some people.

But no worries. As much as I am touched by the kindness around me I look forward to the day it will not have to be so obvious and necessary. I look forward to being taken for granted. (Okay, that last bit is dishonest. I hate being taken for granted! Ah, the song of a mom of a teenager.) Let’s just say, I look forward to the day when I am not taking up so much space in the worry parts of people’s brains.

In the meantime, keep the prayers and positive vibes coming. I’ll send mine your way, too.

Categories Feelings