Disappointed with Care Team
I've been in treatment since October 2011. That's ten months of about a million doctor's appointments, lumpectomy, chemo, mastectomy, radiation, blah, blah, blah.
In all this time, not one of my physicians has ever said anything remotely related to "how are you dealing with this?" No "Are you scared, are you in a support group, do you need a referral to a counselor, do you have help at home, how are you managing?" Nothing except a fragmented approach to the cancer in my breast. I have become a diseased breast with a woman attached. Loosely attached, and apparently of no particular interest to the medical team.
I'm so disappointed. What happened to treating the whole person? Where is the compassion? What do the rest of you do to cope with the spiritual distress that accompanies this miserable disease?
Comments
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My oncologist is a very kind and positive person. Had I asked for a referral to a support group, I'm sure she would have given me one. But I'm not a support group type of gal...I find that hysteria feeds into hysteria, and I didn't need anyone else ramping me up even more. The decadron did a stellar job of that on its own. My onc didn't hesitate when I asked her for some xanax, though, and that certainly helped me cope!
I was treated through my HMO. I realized even then that my doctors and nurses barely had time to treat the disease, let alone address any personal crises I was having. They see so many patients each day, and many of them, I'm sure, were in far more distress than I was. I'm wagering a guess here, but I bet that, to some degree, they do see us as a particular disease/cancer. Oncologists and surgeons are trained to fight that disease. Psychologists are taught to treat the psyche. Just recently, during a routine appointment, I asked my gynecological oncologist about a patch of dry skin I had, and I might as well have asked him to explain nuclear fusion! Just not his area. So if you are in need of counseling or a support group, speak up! Or, if you have difficulty doing that, is there someone--a friend, a spouse, a relative--who could act as your patient advocate?
As far as what I did to cope (other than xanax), I shared my fears with my closest friends and my boyfriend, took long walks and hikes, kept busy, and always kept sight of my goals. I told myself daily this was only a short chapter in my life, and everyone has these dark chapters, and things would be back to normal (at least close to normal) before long. And that's exactly how everything played out.
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Drs. are trained to diagnose, treat and then check off. I had horrible, horrible pain and both Surgeon and Onc. Dr tried to give me more Vicodin after checking to see that THEIR work/treatment was OK. Eventually saw a physical therapist and she helped me way more than any of my Doctors. She would discuss things with me, but made it clear that she wasn't able to " Diagnose". Only the Dr. can "Diagnose" ! Sometimes they can't! They couldn't tell me what was causing my horrible pain. Onc. Dr. only wants to talk about the chemo and what he's doing to my body. To the onc. Dr., you are a "diseased breast attached to a woman." I did go see a counselor and it was good. I still remember talking about all I had to do and she said "You have to be your own advocate. That must be a lot of pressure?". Isn't it sad we have to be or own advocates?
Coming here to the discussion boards is the best place (for me) for any kind help for: mental distress, spiritual distress, social distress, family distress and any other kind of stress. The ladies here get it and always have an idea to help.
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Do you have a family physician?
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Hi,
I really enjoy your blog. Yeah, I haven't gotten much in the way of "how are you coping?" from my treatment team either. The cancer center gave me a folder full of resources including support groups, special exercise programs, wig and prosthesis shops and the like. They also have a clinical social worker on staff and included his card. So I figure I'm on my own to pursue that type of support.
As to how I'm coping, I'm figuring it out as I go. I write, meditate, and look for inspirational reading. I'm trying to stay connected with caring people. I'm a bit leery of support groups but may pursue that when I have more time. Right now I'm still working part time. The distraction helps.
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I'm sorry your team hasn't helped in the way you need. Have you looked into a cancer social worker? They are through hospitals, are free, and are there to help you navigate the system, support and all. Mine helped a great deal, even lead a support group herself. I also went to an integrative naturopath while in treatment, and they were very concerned with how I was doing, treating all of me. They were part of the hospital, exclusively worked with cancer patients in tandem with your onc. My appointments lasted 30 minutes or better, directly with the doc. Both were great for me & I'd recommend finding one or both in your area. Good luck.
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I was treated locally (Palm Springs/Palm Desert area) and also UCLA, and in both settings, a psychologist or oncology social worker were very prominent from the very beginning, right through rads. So it's kind of surprising to hear that no one has filled that need for you.
In what part of CA do you live? I know UCLA has wonderful support groups run by their psychologists that are open to non-UCLA patients on an availability basis. Here's a link to some of their info: http://www.simmsmanncenter.ucla.edu/groups/groups.asp
It's not only helpful to have someone to talk to at various stages in our tx, it's also important that you find someone with a real understanding of bc and bc tx. As a UCLA psychologist said to me, this is not the time to be explaining to someone what bc terminology means. You need someone who knows more than you do about the disease, your tx, and the healing process, which probably means making an appointment with someone at one of the larger institutions -- UCLA, USC, Cedars, Stanford, UCSF, etc., depending on where you live. I do hope you can find someone to give you the support you need and are seeking! (((Hugs))) Deanna
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I'm so sorry you're dealing with this, I understand. You're not alone, I've been disappointed from time to time with something since all this started. On occassions I found some not very "user friendly", some rude and some just don't call with results...which makes me so mad. I'm on my 4th onc., some not by choice (we're military and some have moved). I love the one I have right now...so far. You would think people who work with cancer pt's would be more compassionate.
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My docs are not exactly huge care bears either. One of my oncs, a resident, was really good though. She didn't DO anything really, but she took me seriously, listened and encouraged me to exercise and "live my life," as she put it. It helped.
In the beginning, when I was totally freaked, I got a xanax script from a shrink friend, and when I told my cancer docs, they assured me that it was fine, that I shouldmtake whatever I needed to manage, and my surgeon did also tell me that it was normal to freak, but that if I was still freaked after 3 weeks or so, to tell him so he could get me a psychologist specializing in BC.
So they have not been amazing or anything in this regard, but they have been OK.
The thing that ultimately helped me the most was my wonderful PT. About a month or two out from the BMX, I insisted on a referral to one although the doc saw no reason. I went to her for lymph draining massage once a week throughout my treatment and for a while after too. She was nice, a font of knowledge about docs, treatments, complications etc and what she did felt good, a complete oasis in a sea of unpleasant treatment, needles and pain.
The other thing that helped was exercise, especially walks with the dogs. When I am not sure what to do, I go for a ong walk. I always feel better afterwards. It helps that the weather is mostly good here and that I can walk among the antiquities. I realize it is not so easy everywhere. -
Hey SB
- I haven't really gotten much support in that regard either from MO, RO or PS but one of my infusion nurses had breast cancer too and has kids the same ages as mine. She was/is awesome support to me mentally. I know I can go to her with questions. I see my infusion nurses every time I get my port flushed. I also have a friend who is 17 years out and she's been a huge support to me. Actually I have a few friends/neighbors who had BC so I can go to them too and I have. I think fellow BC patients are the best support as is evident with breastcancer.org.
I was given a pamphlet about breast cancer survivorship to contact for a transition visit with a breast cancer sruvivorship expert. I haven't made that appointment yet. I think the RONP recommended to make it in September.
I have really found some peace in meditating. I did a 21 day challenge recently (loved it) and I've also purchased some meditation cds from amazon.
I also go into every appointment with a smile on my face and have a positive attitude toward my treatment for the most part. So, they don't probably see that I need any support or anything. I said to myself it's going to be a tough year of treatment and it was/is and amazingly it's almost over. I'm done active treatment and I will have my diep surgery in early 2013.
I've had minimal side effects too. You are going through some rough things with your SEs and your sister. I think you have to ask where to get help because the MO doesn't want to deal with that during an appointment. Please ask your MO for a recommendation of someone to talk to about all of this. I'm sure your breast center has a counselor for you to make an appointment.
I walk most days with DH and my Reiley (dog) and I know you like to bike. Keep it up. I too think exercise is very important. Getting out in the fresh air helps me so much. I walked through all of my chemo (super slow some days!), surgery and radiation. I think I only took a few days off from surgery but I was sleeping most of those days anyway. LOL
Some people like to keep a personal journal too. It will let you release some of your feelings too. I know you have a public blog and that is good too.
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When you go to specialists, they well, specialize, I guess.. I know where I had chemo, they asked if I wanted to talk to someone, the social worker came over, gave me her card, said if I wanted to talk, call any time, even after treatment ended, that they were there for us. That was nice of her. It seemed like the nurses during chemo were the ones who talked the most with patients - but then again, we were a captive audience, and they were limited in their work by the number of chairs, so they had time.
Your surgeon is there for 1 reason - surgery. The MO is there to make sure your chemo is going smoothly, then to follow up at regular intervals. Your RO makes sure you do well with radiation. If any doctor should've been the coordinator, it probably should've been your PCP. That's the general who dictates the rest, who treats the whole person, as much as any doctor does these days.
When HMO's pay by capitation or a teeny amount per visit, when PPO's pay a fraction of what's billed, when Medicare caps reimbursements, it's no wonder that doctors don't have time for anything like that - they need to see enough patients to be able to pay for their malpractice insurance, office rent and staff.
If you know you want to be referred to a support group, why not ask the office staff to give you a list? I've found that no matter what the situation, if you ask for things, people are very nice, and tend to go out of the way to help you get them. Be proactive!!!
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Well said, itsjustme10,
I agree that this whole ordeal can be overwhelming but just as with anything in life, you have to ask for what you want. You said it, be proactive.
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You have all brought up many valuable perspectives. Like Goodie, I go into my appointments with a smile and a positive attitude, and perhaps everyone around me just figures I've got it handled. And aside from the moments of fear, of feeling overwhelmed and exhausted with the daily discomfort and fight, I do.
Thank you all for weighing in, and for your compassionate and helpful responses. I originally posted in a very low moment, and I appreciate your support.
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