Tag: Treat

I pinky swear I haven’t forgotten how to be grateful. I’m just not taking things as well.

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The last couple of years have been really hard. My children were sick. We have all been “living” with a pandemic raging around us. I battled cancer. My husband tried to die from a heart attack. The list goes on. I know I know. You all know this already. Despite all this, I have continued to make it my mission to be a beacon of positivity unlike the planet has ever known. I am constantly in search of the bright side or the retrieval of the positive, no matter how small a portion it is. I get signs from the universe all the time that this is what I am supposed to do. I have had complete strangers reach out to me for help and guidance, which I love and I am happy to give. That is truly me in my element: helping people. I wouldn’t trade it for the world.

So, I have spent all this time being tough and positive…still am. However, I find myself struggling a bit lately. It’s all fun and games when everything is going my way, so to speak. But, I have noticed sometimes, that when something doesn’t, it kind of crushes me for a hot minute before I can get a hold of myself. I start resenting and complaining, or freaking out all together. This kind of reaction is somewhat foreign to me and I find myself saying “Whoa Katz. Get a grip why don’t ya? You have been through way worse shit than this for chrissake!” ” You are alive! Does anything else really matter?” Most of the time that works, but I find myself having to do it more and more often lately and that bothers me.

Part of me realizes that there is an element of PTSD circulating around my brain with my serotonin, trying to convince me that there is only a matter of time before another shoe drops. It insidiously permeates my life still, forcing unreasonable reactions and fears. It is pretty par for the course after what I have been through. I think that my goal for now is to stop trying to push it away and acknowledge it and deal with it. I think that by trying to suppress it, I am actually giving the PTSD more power than it already has. I assure you that I have been taking all the outward steps: showing up to counselling, reading about it, talking to myself like I said, nodding when my therapist explains it to me. But, I really haven’t been doing the internal work. I have been so busy pushing forward toward my happiness mission that I haven’t really allowed myself time to recover or react.

This really smacked me in the face last Friday. I went for my routine mammogram. Some of the same techs were there that were with me last year when all my cancer stuff was ramping up. I got my mammogram done and those 45 angle views really pulled at my lymphedema on the side of my neck and it started to throb and hurt. Everybody did everything right..and I should have expected this to happen and prepared, but I didn’t. Instead, I laughed it off at the moment and went upstairs to my office, only to start bawling my head off in a flood of cancer memories the moment my MA asked me if I was alright. I just couldn’t stop. One memory/flashback after another started just flooding me over and over. I actually had to leave the office and felt really guilty doing it on top of it. I knew I just couldn’t be my best self for patients though. I literally cried half the day as I reexperienced everything from the whole last year all over again. Sheesh.

My point is, that I really have missed the boat on recovery and reaction somewhat. The strategy I thought was helping me “not to wallow” was actually preventing me from processing what was going on with me. I pushed it down and just kept pushing forward instead. By not allowing myself the time to really go through things…..while I was going through things…..I didn’t really do myself any good. Sure, I got through my cancer experience and survived. That is definitely a win. But, I bottled so much stuff up that now it bubbles over when I don’t expect it. That’s no good either.

The bottom line is that I am very grateful to be a survivor and I love helping others survive whatever they are going through, life-threatening or not. But, in order to truly survive and thrive on top of that, I have to allow myself to process and react to experiences when I have them. I need to not punish myself or second guess reactions and just….have them. I have to realize that, no matter how tough I am, I am still human. I need to give myself the same consideration and time that I give to everyone else. I promise that I’ll work on it.

Dr. Katz

My colonoscopy experience was awesome!

Ok. Ok. I know what you’re thinking. Eeew. How is that possible? There is nothing good about a colonoscopy. Am I right? Well, yes, you are right. A colonscopy is kind of shitty…pardon the pun. What I am really referring to is the experience and how I was treated. Let me explain.

I chose to have my colonoscopy NOT incognito, but at my local hospital Promedica Monroe Regional, where I go to work every day. Trust me, these people have seen the best and the worst of me for over 20 years now. They have saved my life multiple times, helped me in the OR, helped me deliver babies, etc. We have listened to each other. We have complained together and rejoiced together. Sometimes I see them more than my own family. But wait, they are part of my family! They are just not the family I live with. So, why not let them in on my health too?

From the moment I walked in, all crazy haired and no make up on,(yikes) they greeted me like family. We joked and laughed while they checked me in, while still making sure that all the proper protocols were followed. They managed to treat me like a patient, a doctor, and a family member all at the same time. Bravo! I almost cried…literally. Everybody stopped by to see me. They explained things as if I was fresh off the street with no medical knowledge. That might annoy some people/docs but I love it. We should explain everything to everybody. You never know if you might have a total brain fart about something you do every day….when it’s actually YOUR turn! As a matter of fact, I was stressing more about this stupid colonoscopy than I did about all my cancer stuff and chemo and procedures for the last year and a half. What the heck?! It was as if I just couldn’t handle the thought of maybe even one more thing being wrong. Thank God they treated me like family. It put me at ease right away. They went over and above. I have never considered myself on any sort of VIP terms because that’s just who I am. I even asked them why the special treatment? You know what they said?

Doc, you been through a lot and we all love you. We just want to take care of you like you take care of us. You are one of our own. I think my heart about burst out of my chest, in a good way, right at that moment. I realized then that they do see me. They see how much I care. They see how hard I try every single day, because I want to not because anyone tells me too. We have a mutual respect. I try to treat everyone well in the hopes that they treat me well. That’s what a team should be. It’s what I love about what I do. Well, I have to tell you, the ProMedica Monroe Regional Hospital team was the best I’ve ever seen! See you at work Monday guys! I love you!

Dr. Katz

How am I ever going to have an ache or pain again without panicking?

You know, when I am all done with all this cancer stuff, when the last treatment is over, when the last scan has been read as clear, I will never really be done. What I mean is, I will have to follow up regularly for at least the next five years, if not forever, depending on how things go. It will be like a little shadow over my life probably for the rest of my life. There is a post traumatic stress element to having gone through any illness like this that is not likely to disappear any time soon. How am I ever going to have what seems like a normal ache or pain without overthinking it? What if that little ache is my cancer coming back? I already HAD normal-ish symptoms seemingly consistent with menopause and overwork….and they turned out to be cancer! Yes I know, I know, the growth was not a normal symptom, but you see what I mean about the rest of it right? You see? I am not even done with treatment yet and I am already pre-thinking about overworrying. Oh for heaven sake.

Being diagnosed and treated for cancer is in itself a stressful and potentially traumatic situation. Patients experience a whole range of feelings including fear, sadness, anger, anxiety and adjustment issues. There is such close association with cancer patients and post traumatic stress that the DSM-IV post traumatic diagnostic criteria were expanded to include diagnosis with a potentially life-threatening illness as a possible stressor significant enough to induce PTSD. The DSM-V PTSD diagnostic criteria allow for specific implications of cancer- related post traumatic stress, but there is still a lot more research needed in this area. Studies done by Mehnert and Koch showed that 54% of breast cancer patients viewed cancer as a traumatic stressor. Andrykowski and colleagues interviewed survivors of lung cancer and found that 37% viewed their diagnosis and treatment as a traumatic stressor. There are other studies that reflect similar results. Still other studies correlated the incidence of cancer related post traumatic stress to lower socioeconomic status, young age, limited social support or dissociative symptoms regarding the cancer experience( Not being able to recall any cancer related discussion with the doctor.) The bottom line is that cancer is considered a traumatic stressor by some patients. There just isn’t enough data out there right now to describe the entire course of cancer related post traumatic stress, but we know that it is out there.

So, now that we know it exists, what do we do about it? I think the key is integrating psychosocial support into the acute care phase and survivorship phase of cancer care. I think it is important to make therapy and mental health care directly available in the oncology setting, not as a completely separate venture in a different location. A lot of patients, myself included, have a difficult enough time getting to their regular oncology appointments, much less a whole separate group of appointments with a mental health professional. I think it is also important to take a detailed mental health and trauma history on every cancer patient from the very beginning. You need to know what background you are dealing with even before the intense stress of cancer treatment begins. If a patient already has an extensive trauma or psychiatric history, they are a set up for post traumatic stress with cancer treatment. Maybe if you are able to highlight that risk ahead of time, the patient can already be directed into mental health treatment before the stress of cancer treatment takes root. It is also important to continue to monitor distress and stress as treatment is ongoing. Ongoing screening for distress is already a component of the National Comprehensive Cancer Network’s clinical practice guidelines. There are specific pathways for management of acute stress, traumatic stress, and adjustment disorders. I think this is the very checklist that I have to go through every time I go to the doctor’s office. I also have a list of mental health support resources, but they are in a different location than my doctor’s office and it is still up to me to seek them out and make arrangements.These checklists and protocols are great, but they mean nothing in the grand scheme if the availability and connectability of mental health treatment is not easily and readily available. I still feel like it would really be up to me to bring up if I am having any mental health issues when I truly think it is the doctor’s role to watch for these signs even before I would bring them up. As a cancer patient, your mind is whirling all the time. You really do need some one watching out for you to clarify some things that you cannot clarify for yourself as readily. I am not saying that cancer patients are all helpless or anything. I am just saying that we may need a little extra support or supervision than most with everything else going on that potentially distracts us from caring for ourselves. Post traumatic stress is real. Now that we can identify it, we need to get better at addressing it.

Dr. Katz