Archives for posts with tag: Healthcare providers with cancer

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I had a great first day back at work yesterday. I’m so glad that I took off extra time to recover from this surgery. I have two more full clinic days and then I have Th and Fri as paperwork/healthcare visit days.  

That’s actually a full-time schedule, which was not the plan. The was a scheduling mishap by either a parent or myself, which I resolved by scheduling a full day of testing with a teen on Weds.

Now before you start wagging your finger at me, keep in mind that next week, I have no one scheduled! I had cancellations and did not fill in the spots. And although the schedule snafu family could have come in next week, they have already waited 4 months to see me and the mom says they’ve been ‘marking the days off on the calendar’ until their appointment, which they had thought was yesterday when I was scheduled to see someone else. Fortunately, the snafu was discovered last week. It meant a lot to the mom to only have to wait an additional two days instead of seven.  

My popularity, while good for business can be stressful. There is a shortage of specialists in my area coupled with high demand. But I love my job and after all, I got three hugs yesterday!

This post was inspired by the Health Activist Writers’ challenge for the month of April. I write “inspired by” because I have yet to use one of their suggested daily writing prompts.

As a child psychologist, I am often advising the mothers of my patients to take more time for self-care. A frequent response is, “I know, but I just don’t have time,” to which I reply, “If you feel you have no time for this than you have been without time for yourself for far too long and this is even more reason to do it!”

I know I am asking a lot of moms who are already taxed with parenting, work, and household responsibilities. I have struggled with the same life balance issue myself over the years, especially since becoming a mom 14 1/2 years ago. One of the valuable lessons I am continuing to learn as a breast cancer patient is to take care of myself, I mean REALLY take care of myself. It’s not that I was living a martyr’s life but I was not taking sufficient care of my health. To do this properly, takes time.

In 2002, I was laid off from my very first job following the completion of my post-doc. To make a long story short, the job was ugly. It was the first time in my life that I was treated like I was incompetent. Down deep I knew that I wasn’t incompetent but to be treated this way for nearly three years in my first “real job” and right after becoming a mom was a major blow. The lay off itself was done in a fairly nasty and unfair fashion. It was toward the end of that job that I had my first of two incidences of Major Depression. (The second incidence occurred a couple of years later but only lasted 2 weeks because I got back into treatment immediately after recognizing that I was not myself). It was BAD. It wasn’t just sadness, which is what a lot of people mean when they say, “I’m depressed.” I had no appetite. Food was flavorless. I lost 10 pounds in a week. My sleep was messed up and I had to will myself through each day to have enough energy to parent Zoey who was a toddler at the time. She has always been an empathetic girl and at the time, was learning to read facial expressions. I remember feeling heartbreaking guilt and sadness one day. She was sitting in my lap, looked up at my face, used her fingers to push my mouth into a smile while anxiously asking, “Mama happy?”

Being laid off and depressed was a major wake up call for taking care of myself. And since I was laid off and able to collect unemployment for a few months, I was able to make use of the time to figure out what to do with my life professionally. At that point, I decided that I would never rely on one source of salary again if I could help it. So in 2002, I applied and tested for my psychology license in Washington state and in 2003, started my private practice. Meanwhile, I was writing research grants and ended up being employed through two of them, the longer one landing me on the research staff of the Social Development Research Group at the University of Washington. I worked there until 2007 until the research money ran out. I was unable to secure funding for more grants. As the money ran out, I expanded my practice and then by the time I left U.W. in April of 2007, I was able to build up my practice to full time. Although being in private practice had not previously been an aspiration of mine, it ended up being the perfect job for me.

So although I would not have taken that job had I known what it was going to be like, I got some very positive life lessons out of it. Also, I made a number of friends at that crazy job including my dear friends, Jennie and Lisa, whom I’ve mentioned in my blog. Hmm, taking the opportunities afforded by crappy life circumstances to glean important life lessons? Gee, that kind of sounds like my breast cancer experience thus far.

Fortunately, I was able to use some of those life lessons from my crappy job experience to cope with my breast cancer better and to avoid getting depressed again. Sorry, I hate being depressed. And yes I have grief, but healthy grief and clinical depression are not the same thing.

So having breast cancer and especially the time off after my major surgeries, has given me some time to revise my life plan so that I am a happier and healthier person. As I mentioned previously, taking care of myself takes time and emotional space. I will not always need this much time and this much emotional space but right now I do. At first, this was a hard adjustment for my husband because healing has meant my being more emotionally distant than usual. (And no, I don’t just mean less sex.) We had to develop different ways of spending time together, for example, John started accompanying me on my walks on the weekends. He also eats all of the healthy dinners I make ahead of time in reasonable dinner-sized portions and freeze. The walking and the diet change have been part of the reason that John has lost 22 pounds. My taking care of myself has also meant that John had to take on more responsibility and learn how to take care of me after surgeries. It has also meant John taking care of some of his own health issues better.

For Zoey, my cancer has meant worrying about a parent’s mortality at an earlier age than average. It has meant seeing me less energetic and weaker at times. But overall, I am very happy to report that Zoey has more than risen to the challenge. She fairly quickly snapped out of the angry, eye rolling teen stuff that she was directing toward me and started treating me much more respectfully and affectionately. She is often there with a glass of ice water when she sees me fanning myself during a hot flash and she secretly changed my screen saver to a banner that reads, “I love you, Mom,” just because. Sure we have our moments and she is still able to be disrespectful and her eye rolling muscles aren’t totally lax. And having a mom who is a breast cancer patient when she is a 14 year-old girl makes her life harder. I wish she didn’t have to go through this. But she has grown enormously.

Finally, by taking care of myself, ultimately, I will take better care of my patients. Some of them are feeling a little anxious and impatient because I am off work again for an extended time. But if I don’t take care of myself, I will not have enough energy to do a good job. And as my dear friend, Nancy points out, by taking care of myself and coping positively with a major life stressor, I am modeling valuable skills for the families I see.

So even though the villagers were not initially happy with my changing my life to have a stronger focus on self-care, ultimately, my self-care is reaping benefits for the villagers.

I do believe that there is more than one good solution to every problem but perhaps this lesson could be helpful to some of you readers out there.

 

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So yesterday was my day of hapless mess-ups and feeling bad about how disorganized I feel. Right after I posted, “Chaos“, I had more. I realized that I’d forgotten about another patient appointment that I’d neglected to cancel for my sick day. Luckily, I realized this fact 45 minutes before the actual appointment time. I jumped into the car wearing jeans and no make up and got to the appointment about 30 minutes early to regroup. At least I had showered that day and was wearing clean clothes, which had not been true the prior two days since I was convalescing with my cold.

Do you know how I forgot these two appointments? Remember when I went all Golem after losing my my schedule for a single day because my smartphone got wet? But in that day, I scheduled several appointments, which I had to record elsewhere while my phone was drying out on its little bed of rice. When my phone came back to life, I know I went through my notes to make sure that all of the new appointments were recorded on my now alive phone. Since checking this again, I discovered that I did update my schedule correctly every day between 1/14 and 3/11 (the date of my surgery) except for one date. Yes, that date would be 1/14, the day I tried to take off as a sick day.

I’ve decided that all cancer patients deserve a personal assistant to help them maintain their schedules, especially if they are the schedule keepers at home and at work.

As you know, I was pretty bummed and overwhelmed yesterday. But I rallied. Tomorrow is another day. This morning, two families showed up to see me at 9:30 am! My schedule indicated that one family had arrived 24 hours early for their appointment. I felt terrible. I figured it was my fault since I have been so discombobulated. I apologized. Fortunately, the mom knows about my health status so she didn’t yell at me or anything. I was very apologetic. They are coming back tomorrow.

I knew that the appointment had been scheduled by email. I wanted to see if I had made the error, in which case I would discount my fees for this family.

To my astonishment, I saw that I had sent not one but two emails saying that the appointment was for tomorrow and I also confirmed that this was the date the mom had requested for the appointment.

Phew! It is a little lame to be so happy about this. But I will take whatever slice of sanity I can get.

This post is from 6/7/12. I don’t know if it is the best written of my posts and it certainly isn’t the funniest but it describes a painful part of this experience for me as person who is more accustomed to a caretaker role. I had to adjust to accept help and support and also to knowing that I was asking more of my support system than I could paid back. I hate that! The harder part, however, was telling the parents of the patients in my practice. I also ended up having to tell some of my patients, who are children and teens, when I had to take off 4 weeks after my mastectomy.

I know that my illness has impacted the families I see in that they are less able to depend on me always being there for them. I’ve since had to do professional consultation to assess whether my illness is significantly threatening my competence. This kind of consultation is required by professional ethics and following the ethics code is the law. Since I had already shifted my practice to primarily doing evaluations instead of psychotherapy (I needed to get home earlier and psychotherapy needs to take place during the after school hours, otherwise it is too disruptive for kids), most of my patients were at most inconvenienced by some rescheduling and my needing an extra day to return phone calls or emails. But there were a couple of kids who I thought were going to need me to be more available than I can be in the spring with my TRAM surgery, so I have transferred their care to other providers. Fortunately, the fact that I don’t look sick and actually look healthier than before my diagnosis has been really reassuring to folks.

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.

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