Category: Emotional Support

Post op day 10

Today, I woke up and noticed a change- my body felt like my body. For the past 10 days I have been having pain, decreased range of motion, inability to pick up objects 1 pound or more, and a feeling of heaviness. The feeling of heaviness has bothered me the most. I have arthritis and all the other things come when my arthritis is acting up. However, the feeling of heaviness has disturbed me the most. It comes from my port. I can feel the weight of it. It presses against me and was noticeable with every breath I took. Today, it wasn’t that ever present foreign invader but a part of me. I didn’t have to think about each movement I made, whether it was turning my head or raising my arm or simply just breathing.

The course of cancer is filled with bumps, hills, and mountains. It is nice to have a moment where the path is smoother. I don’t know how many smoother days I will have, but I want to make sure I have a way to make the most of it. I decided to make a list of things that I really want to get done when I feel good- a cancer bucket list if you will. For me, I believe that it will help me feel energized. The buckle list could include anything from projects to work on, cleaning and organizing, seeing family and friends, or just taking a moment to enjoy the day. One of my things on my bucket list and in fact the first thing I decided I wanted to do, was to eat my favorite foods before chemo started. I wanted to make sure that I could enjoy the meal to the fullest in case chemo changed my ability to taste food. Today I am going for chilaquiles and for Chinese barbecue – not at the same time of course- but my day will be filled with good food and plenty of outside time. The other thing I will do today is fill out the rest of my bucket list. Just the thought of that has reinvigorated me. It is amazing something so simple can be so empowering. Empowerment is all too fleeting and I am going to take it when I can since I don’t know what is around the next corner.

Post op day 9

The realization of the change in my ability will be an on going struggle. I have written before about this struggle. Today it is rearing its head again. I slept most of last week. I have finally woken up and looked around and saw all the things that needed to be done. How do I tackle everything that needs to be done? Where do I start? What will I be able to do when my chemo starts? All of these questions plague me. I am sure this overwhelming feeling will occur time and time again in the future. It is time to take a deep breath and reevaluate my goals. This struggle reminds me of the words from a theorist, Winnicott. Dr. Donald Winnicott was a pediatrician and psychoanalyst who studied children’s relationship with their mother. He saw that imperfections with the mother benefited their children more than when mothers were perfect. He writes:

“A mother is neither good nor bad nor the product of illusion, but is a separate independent entity; the Good-enough mother… starts off with an almost complete adaptation to her infant’s needs, and as time proceeds she adapts less and less completely, gradually, according to the infant’s growing ability to deal with her failure. Her failure to adapt to every need of the child helps them adapt to external realities.”

The concept of good enough is a powerful concept that speaks to the drive for perfection and it is not necessarily the healthiest drive. Our imperfections and failures can do more for us to grow and become stronger than restricting ourselves to be perfect. Sometimes in the midst of challenges or tragedy we must take a step back and allow ourselves to strive to be good enough. This is not to say that we shouldn’t try to be the best we can, but our perspective of who we are may be better accessed by the strive to be good enough and accept our failings as a moment of learning. It is through my failings now that I have been able to allow for the support and care from my family and friends. It is through my inability to be who I was before that I have grown closer to my loved ones. It is through my mistakes that I have learned to appreciate other aspects of my self. I have started writing, a skill that I felt was rudimentary at best. Everyday I write medical evaluations, progress notes, and letters. I have always thought that my words were clunky and my grammar unsophisticated. However, now that I write about my experience, I feel a different part of me is developing. I find I like this new me that is emerging. I started writing this blog because I couldn’t do much. I am fatigued and achy. I cannot pick things up, dress my self, cook or do most things as I used to do. But I can sit and read and write. I would never have started this website if I hadn’t failed at being who I used to be.

In this time, that change is inevitable, and failure is part of the picture, finding that good enough self may go a long way towards finding your new self- a self that you might really like.

Post op day 5

After sleeping for 4 days straight, I can no longer sleep. I am up before the rest of the family is up. I decided to make myself a cup of coffee and eat some yogurt- things that I had already set up to be able to do without anyone’s help. It really gives me a spark of hope when I can do things on my own. I tend to be a very independent person. Like many women I take care of a multitude of things at the same time- my household, my child, my husband, my work, etc. I had worked years without a medical assistant and when my hospital told me I had to have one I didn’t know what to do with her. She is great and found a way to make my work day better and really has added to helping support my patients. It took her a while to crack my independent, I don’t need help shell but she did and I am grateful for that. One of the things that I was most concerned about when I got my diagnosis was that I would have to rely on others. I would lose some of my self. It is a very daunting task for me to give up a part of me I am so comfortable with- a part that I am so proud of. My desire for independence needed to balance with my change in life and the need to let others do for me. One of my friends so aptly pointed out that I should allow others to do for me what I do for them that in this way I would in fact be helping them. Odd but true.

So what can I do? What can anyone do? Part of my own search for balance has to do with my understanding why I strive so much to be independent. What does that mean for me? Growing up, I was not very independent. I was very spacey and needed much help. I would get lost going to the bathroom. My parents tried desperately to teach me to be independent. I knew how to cook, clean, sew, knit, crochet, change my oil, change a tire, rewire a lamp, patch walls, repair a multitude of things in the home, but I still relied on others. My freshman year of college was an eye opening experience for me. I realized one day that I knew how to do many things but really couldn’t do them without someone telling me what to do. For all of my knowledge, I felt helpless and powerless. Independence to me meant not only growing up but it also meant empowerment. I strove to find my independence and by the time I graduated medical school, I decided I needed to really spread my wings more and I moved to California for my residency. Living in California was great. It helped to really form who I am today. But now I need to find a way to still feel empowered but be able to get help. That for me is a tall order. It has been over thirty years since that fateful day in college. Thirty years of being a strong independent go getting woman. Thirty years is a long time.

These are some of the things that I feel I must do to find my balance.
1. Find simple things I can still do for myself. Such as the feeding of myself with my yogurt that I have made or set up stations that are accessible for me like my coffee station or a place that fruit and nuts are that I can just pick up. I have clothing that is easy for me to put on and take off without much arm movement (still can’t raise my arms well).
2. Find new outlets to still feel good about what I do. This blog and website is a good example. Much of my identity is wrapped up in helping others and teaching others. Even though I cannot go to work right now, I can write and feel by sharing my story, I could be helping others as well as packing my site with information.
3. Understand that the support people wish to give me is due to love and not my own weakness. My friend is right. I have done much for others and rarely let others do for me. My letting them do is really good for them. I am still struggling with this concept but she is right.
4. Identify things that I feel I can give up to do for myself. Delegating is a skill I needed to learn at work, I can learn it in my personal life too. Starting small and working my way up to bigger things. This is clearly a work in progress.
5. Most of all I need to let go and not worry about theses changes in my life. I need to let my life evolve and learn from it along the way.

I am sure this will be a struggle that I will constantly be in throughout my treatment and beyond. It is a natural part of growing old. I always found it ironic how we do everything for our children as they grow up and one day they must take care of us. I see it time and time again with my elderly family members, friends, and patients. It is hard to give up independence.  But by giving up some of my independence, I am allowing others to show me their love.  Love is a very good thing.

Post op day 2.

This morning I woke up in pain. After minimal pain post op day1, I immediately went there- I am worse! I needed to collect my thoughts and I went and examined my wound site where the pain was. The pain was coming from my port. It has been red and I was monitoring it. I rushed to see the area and saw with much relief that it is less red but had a large bruise surrounding it. This is a normal part of healing. Nothing wrong. I let my breath out and sighed. I began to wonder though about set backs that women will go through. I thought about what would I say to my patient that had a set back with treatment. Setbacks can be both emotional and physical (medical). They are normal and it would be unusual if you never had a setback. It is important to recognize that and find ways to help yourself during a setback.

Here are some steps that might be helpful:

1. Understand the course of healing. Remember, sometimes perceived setbacks are part of normal healing. In my case, my increased pain came from my bruising and some amount of swelling. I had not been feeling as much pain and had stopped using pain meds and stopped the cold compress on post op day 1. Along with bruising is swelling of the site. Bruising and swelling should peak around 3-4 days. I was day 2, so increased swelling meant increased pain. My site is not more red nor is it hot. I am ok. I took some Tylenol and got some coffee.

2. Know when to call your doctor
Your doctor should give you an information sheet about what to look for and when to call. In general the guidelines post op are
a. Call your doctor for temperatures 101  degrees F or more. There is sometimes a slight low grade fever post surgery.
b. If you have increased redness that is spreading and hot
c. If you have new redness around the incision or there is pus coming from the wound or drain
d. Bleeding at the wound site
e. Swelling in your arm or hand that is worsening. Small amount of swelling is normal for up to one month post surgery and can be relieved with elevation of arm.
f. Increased pain not controlled by pain medications
g. Increased drainage from surgical drain (greater than 240 cc or 8 oz in 24 hours)
h. Misc problems such as shortness of breath, cough, dizziness

3. Eat healthy: it is important to continue to eat well. Make sure you are getting a well balanced meal. With decreased appetite multiple smaller healthy snacks may be easier than eating larger meals. You can check out my up coming wellness section for ideas.

4. Drink plenty of fluids. Being well hydrated can help with body functions. If you have had GI problems or any nausea or vomiting ,  replenishing fluids is the utmost importance. The new standard recommendations are to drink to your thirst meaning that you drink if you are thirsty. However, the exceptions are if you are immunocompromised, elderly, living in the desert area or undergoing chemotherapy you should drink 8 glasses of water a day.

5. Have a plan: Make sure you know who you can call if you have a medical or emotional setback. What are the emergency numbers? What are your doctor’s hours and who do you contact on off hours? Who can you call just to talk? Or do you feel better writing or going to a forum? Should you have wellness checks? Schedule someone to check in on you while you are going through treatment.

6. Make small goals. Often times when we don’t feel well, we cannot accomplish things we would like to do. This can negatively impact how we feel. Have some things preset up that can be goals you are happy with. For instance, I had premade individual yogurt servings (recipe in wellness section) and was able to feed myself. I didn’t have to depend on my husband and daughter for everything the first few days post surgery. That was a good goal for me and helped my mood. Find goals that are doable and set them up a head of time to make them possible

7. Use relaxation techniques such as muscle relaxation techniques or imagery.

8. Consider counseling, therapy, or support groups. You do not have to have clinical depression to go to therapy of any kind. Sometimes therapy can help prevent us from become clinically depressed. If you feel you are clinically depressed then please seek help. There are multiple support groups as well as places to get individual therapy. Resources such as the American Cancer Society can connect you with a local group. You can call your church and ask them about counseling services. You can also find local mental health services by calling a hospital near you that has mental health department. The intake for the hospital programs can also give you referrals to other community mental health centers. Therapy can be either supportive therapy (you talk to people for support and listening), Cognitive Behavioral Therapy or Insight oriented therapy. Cognitive behavioral therapy helps to look at our automatic negative thoughts (thoughts that come up automatically when something goes wrong) and helps to change them to be more positive instead. Insight oriented therapy looks at reasons of why your response is causing your mood symptoms and finds ways to change your patterns.

Pink- I must confess was never a color I cared that much for. I grew up a semi Tomboy, as much of a Tomboy that I could be with my Mexican mother dressing me in overly frilly dresses. I loved to play with my brother and his friends, digging in the mud, climbing trees, and playing shooting war games. Pink was not on my radar. I was one of those mothers that was anti pink for my daughter when she was a baby. Trying hard to steer her away from the stereotype of pink for girls and blue for boys. It was my daughter that taught me my first lesson in pink when she chose to have a pink pepto bismol colored bedroom. Sometimes pink is a choice and not a stereotype.

I have recently discovered the symbolism of color. Hillary Clinton’s wearing white for signifying women’s suffrage, red on politians for power. And now I have found power in pink. I was recently, diagnosed with breast cancer. A diagnosis that completely took me by surprise. It was caught on a screening mammogram and not palpable – even after I knew exactly where the tumor was. As I struggled to make sense of my soon to be new world I became drawn to the color of pink. Pink from the woman’s march, pink for the breast cancer color. I began one morning of particular despair chanting “Pink power pink power” and found strength in that chant. I realized the power of pink. This is my journey with breast cancer. It is just beginning. Surgery is my first hurdle. I have decided to use my new found power to create this website. I will be filling it with information I know and also that I discover. Hopefully, my words and information here can help ease the path for others. My prognosis is good but my journey is long. I feel I am already a little stronger with the power of pink- my new best friend.