Wednesday, October 6, 2010

Writing Workshop: Breast Cancer... To Do or Not To Do... Is that really a question?

You can Thank Mama Kat for today's topic of conversation!

Mama's Losin' It


Yes, I did ask what would seem like a silly question to some, but not, unfortunately, to all.

As many of you know, I am a nurse with a wide variety of job experience.

One of my jobs, along the well-worn path I have travelled for 26 years, was that of a Home Care Nurse.

I travelled as many as 150 miles in a day, driving from one patient's home to another, toting the tools of my trade with me, looking as much like a Bag Lady as any found on the streets of Baltimore or Washington, DC...

One Fall day I was assigned to a new case. This woman had had surgery to remove both breasts as treatment for an early stage breast cancer.

I know, bilateral total mastectomy for an early stage, 1st time cancer patient?

But it seems that this woman had a sister, an aunt, a mother, a cousin... who all had had breast cancer.

She was familiar with the treatments offered and decided not to waste time, and the possibility of not being aggressive enough, and skipped to the end... total bilatateral mastectomy with reconstruction and implants.

I was seeing her to perform wound care. She had some problems with the healing of the lower incisions on both breasts and, as it turned out after several years and several revisions, was allergic to the breast implants.

She had the implants removed and she was seen several times a week over the next month or so as the new incisions healed. Quite well now that the pesky allergic-reaction-causing, healing prohibitive implants were gone.

I can't say I got to know her well, but, as one might imagine, we developed a rapport.

She talked about watching her mother and aunt, then her sister and cousin, dealing with their cancer diagnoses and treatments. How it had taken a toll on not just them, but their husbands, children and other family members. She talked about how she feared she would lose her life, her husband, her sense of Woman-ness that made her feel feminine and girly.

We talked alot. Or rather, she talked and I listened.

And I learned. A lot.

It was about the same time that I was assigned another patient. She was an IV patient receiving pain meds for advanced stages of cancer.

As it would turn out, it was breast cancer, and it was killing her.
Slowly, painfully and without any sign of slowing down to give her, or her family, a chance to come to terms with it.

I saw her 3 times a week to check her IV site, monitor her medication levels, just touch base and make sure she was okay... to call Hospice if it looked like things were going that way sooner, rather than later.

As you might have guessed, yes, we too devloped a relationship of sorts.

She ignoring the cancer traversing her body as much as possible.
Me asking her questions designed to make her acknowledge it and the fast approaching end.

One of the questions I asked, but she refused to answer, was how soon after noting the lump, or irregularity, had she sought medical attention.

One- I wanted to know myself and ,
Two- Her records indicated she was in advanced stage 4 when she was diagnosed... only a few months before I came on the scene.

This seemed so wrong. In this day and age of medical miracles and triumphs over evil... how could it have gotten so bad without any sign?

After several weeks it became evident that she was fading fast. Her pain meds were upped and upped and still... the pain was constant and irrevocable.

One Saturday morning she met me with a tremulous smile and watery eyes, from lack of sleep and too much morphine and... something else.

As I leaned in to listen to her heart and lungs, her thin, fragile hand came up to gently grasp mine. I looked down at that blue-veined, tissue paper thin skinned hand that shook with the effort to hold onto my much stronger, tanned and healthy-looking one.

She turned her head to look around the house, to make sure no one else was there, and then slowly sighed.

" Four years ago." It came out as a faint whisper. "Four years ago I felt a small lump. I knew what it was. I was afraid. I did nothing. I knew it would kill me so I lived my life until a few months ago. My husband found it. I saw the doctor. I knew it would kill me, and it is"

The reality of what she was telling me hit like a bolt of lightening. She was too afraid to seek help. Was afraid it would kill her... so she did nothing and she was right. It would kill her... was killing her.

Both she and my other breast cancer patient had found their lumps at about the same time.
But they proceeded in very different ways.

One had gone to a specialist immediately, had taken drastic measures for the chance to live a full life. She had under gone several years of surgeries to get everything just right, but she was cancer-free and was healthy. Healthier than most people her age who had never had cancer.

The other. She had hidden in fear of finding out what it was. In fear of what a doctor MIGHT say or do. She had hidden this from not just her family, but herself.
She was leaving her husband and children before she, or they, were ready. She would not see her daughter grown, her grand children. She would leave them with a hole in their hearts, just like she feared she would.
She did nothing and in so doing, made all her fears come true, which was really doing the worst thing possible.
And she realized it too late.

Too late for her, but not too late for others.

I think she told me the truth so that I could let others know what doing nothing really means. That doing nothing is really doing everything to let the cancer do what it wants.

Please be like the first patient and DO EVERYTHING....

And NEVER let anyone you know or almost know or kind-of-sort-of know Do Nothing.

Oh I almost forgot... They were both 45.
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