I am an oncology nurse. Saying goodbye and grief comes with the job. However, no matter how accustomed I am to this, it is never easy. And no matter how experienced I get with this there are patients who will always leave such a mark on my life that saying goodbye to them will be like losing a part of myself. Today, I said goodbye to one of those patients.
**details have been changed and left out to respect the identity of this patient**
I first met this patient last summer. She was coming to us with her second primary cancer. She is a young mom. She was well versed in the cancer and chemo world already. She is gracious, compassionate, has a beautiful smile, is one of the fiercest fighters I have ever met, and has taught me so much in the last months I have gotten to spend with her. Even if I could share all the details of this patient, I could not clearly put into words what an amazing woman she is.
This patient is one of the ones who hasn't handled chemo well at all, in fact, she is absolutely miserable with chemo. We had every medication on board possible and every alternative treatment we could come up with, but no matter what the nausea came like clockwork. Despite the nausea though, we together as a team would battle through the chemo with one goal in sight... to give her just a little more time with her children. And just a few months ago when she had a clear scan, we danced and hugged and celebrated together.
The type of cancer she has though is one where over 60% of patients with this cancer die within a year of diagnosis... and patients diagnosed when this cancer had already metastasized (spread to other parts of the body) are normally given only a max of 6 months. This disease is awful. But this brave patient stared it straight in the face and lived beyond that 6 months. Unfortunately though, because her disease is so bad that clean scan didn't last long...
Last week I saw her for what I now know will be the last time. In my head I knew it would probably be the last time I would see her.. there is a 6th sense you develop after walking with so many people in their last days.. but there is always that twinge of hope... that maybe just maybe things will turn around. But they haven't and chances are they won't.
Today her mom called into the clinic stating they wanted to give an update. A few minute later before I could realize what was going on there were 3 of us on speaker phone with her as we said our goodbyes. Her body is shutting down and the cancer is winning. And this woman that has taught me so much in the last few months will soon leave this earthly home for her eternal home. I am so beyond thankful for the absolute amazing opportunity to walk with her through her cancer battle. I am so incredibly thankful for the things she has taught me about life. I said it to her and I mean it, I will remember her for the rest of my life. And some of her final words to me will stick with me forever... "Erica every time you gave me a hug at the end of each chemo it was like our victory dance... we did it... we made it through another one..." And as she said those words... I realized just how much a simple hug can mean to someone.
It is for this reason and these moments that I will grieve. I will walk through these awful emotions that go with letting go of someone who has been a part of your life. It is for this that I will allow myself room to heal. It is for moments like this that I will continue to be the best nurse I can... even on the worst of days... even on days where I feel burnt out. I will put my every effort into giving them my all even when, especially when I feel like I have nothing left to give.
I will march through every little victory I can with my patients. Because I am their chemo nurse and I want them to know they don't have to walk this battle alone.
I was debating on my blog topic for this week while sitting and watching the Superbowl. And then the Chevy commercial came on. I wasn't quite sure what it was about, but the look on the wife's face were tears of appreciation and joy and the look on the husband's face of thankfulness and complete adoration reminded me of so many relationships I've witnessed within my job. And then came the truth, it was exactly about that. February 4, 2014 is world cancer day. And while I'm not a Chevy fan, I appreciate that they spent their Superbowl money to raise awareness. Check out the commercial:
I've had this thought running through my head for a few weeks about how it is viewed that my patients need me. They need me to draw their blood, take their vitals, listen to their symptoms and help manage them, help make things clear and explain things, teach them about different things, give them their medications, listen to their struggles, and so much more. Even on the toughest days... the days where I struggle to smile or struggle to focus I know without a doubt I was made to be a nurse; specifically a nurse to cancer patients. It is on these days of struggle that I especially need cancer patients.
I feel strange saying that I need cancer patients, but it is true. I want to make it clear... I have a strong dislike, really a hate, for cancer and wish that it didn't exist, but I have first hand witnessed how something so ugly can produce some of the most beautiful stories. These patients and their families make my life so much richer. Through their battles I learn so much. Through their love for each other I learn so much. Through their ability to show their struggles I learn so much. My absolute favorite aspect of my job is sitting down and talking with these patients and their loved ones. It is knowing that at the end of the day I just don't put medications in them and draw their blood, but that I truly have spent time with them. That when things get tough, they trust me.
I think back on some of my favorite patient stories, and to be honest they are often hard stories, but beauty within them. The young dad who was going home on hospice, but still chose to enjoy every moment he could with his wife and son despite the excruciating pain he was in. The middle aged woman who thought I was crazy because I wouldn't leave her side when she had elevated blood pressure, but smiled at me. I had the privilege of taking care of her almost every shift and her smile sticks in my head and heart. She had a grace about her that few have. One day I came in and I remember the shock I had as I heard she was actively dying. I had the privilege of knowing this incredible woman, and I had the privilege of taking care of her in her last few hours. Her grace shined through in her final breaths.
I remember the man who had ulcerative colitis and on top of that a new diagnosis of cancer. He had a longer medical history than almost anyone I've ever seen. I took care of him for 3 nights in a row. On night one he could barely sit up on his own. By night 3 he was getting out of bed and walking. I have rarely seen such courage, hard work, and determination. It was through this patient I learned what determination truly looks like.
I could talk for hours about the love I have witnessed in so many husbands eyes as they look at their wives. Often these women have lost all their hair, many have had mastectomies, and their color is gone. Their physical beauty is altered by all of this and normally many scars. But this is where I've witnessed what true love looks like. Because in these husbands eyes all I saw was love; pure adoration for their wives. It has been in these stories I've been challenged not to settle. To find a love that is as true as these that I've seen.
Just last week while my patient is facing cancer, which makes so many of my battles seem insignificant, a very special patient wrote ME a note of encouragement. I had had a very bad week (you can read about it here) and this patient was encouraging ME. It is true when I say, I need cancer patients. They make my life so much richer. And I am so blessed and thankful to call myself a nurse of cancer patients.
So as world cancer day is here (or possibly it is after it as you are now reading this), I want to challenge you. Challenge you to learn the stories of the wonderful people who face cancer daily. Challenge you to see how you can help raise money to fight this horrible disease. Challenge you to join in supporting these wonderful people during or after their battle. Challenge you to walk alongside the loved ones of those who have faced this disease not directly, but through walking this battle with a loved one. I promise you won't regret learning their stories.
Trust me when I say, you will not regret getting to know these incredible stories and these incredible people.
How are you going to fight?
3 of my favorite oncology RDs and I
On a final note we want to share in the rejoicing of a miracle of baby Charlie. His mother shared their story here: But this only happens to other people Christa shared this incredible news on facebook just the other day and we are SO excited for baby Charlie and his parents:
"I know many of you have been following our journey, and I just have to let you know about our latest miracles. A little over two weeks ago we began patching Charlie's good eye with an eye patch daily in effort to strengthen the bad eye. The Dr. said that "we could not patch enough". I had high hopes that he would see to of that eye immediately, and things would be great. This unfortunately was not the case. It was very difficult to watch Charlie's happy demeanor change every time we patched him. He would hang his head and just check-out. He would not respond at all to Scott or I visually and that was pretty heartbreaking. It seemed cruel to me to be putting him through this, but we knew we had to stay with it. We began to pray. Jesus healed the blind in the Bible, right? God has brought Charlie this far, so why wouldn't he continue to work in his little life? So we continued to patch, but I needed an attitude adjustment with it. Patching was something I dreaded because Charlie didn't enjoy it, and it's unbelievably difficult to keep an eight month old engaged for a couple hours a day when he can't see. I tried new things everyday to stimulate his other senses, but I was definitely running out of ideas. I was reading one morning in my devotional, Jesus Calling (highly recommend!) and it challenged me to thank God for the very things that were troubling me. Patching immediately came to mind! It hit me that I really should be thankful for the very opportunity to patch Charlie's eye - just 6 months ago we were given a 0% chance of saving his eye. Six months ago the idea and patching and the possibility of having vision let alone an eye were out of the question. How sad that I quickly forgot how far God has brought us. What a mammoth perspective shift! Thank you Lord for that wake-up call. Anyways, that was on the 27th. Yesterday on the 29th Charlie showed his first glimpses of vision in that eye. While we had him patched yesterday he responded with a smile to Scott's silent silly faces. I'm typing through the tears right now because I just really feel like we once again witnessed God's healing hand on our boy. Charlie also reached for and successfully obtained two remotes intentionally. This was amazing! So today we patched again, but this time I laid the remotes out on the floor and he crawled to them! What an amazing God we serve. So we continue to pray for progress and sight, and be thankful for the very things that are troubling us. I'll try to get a video of it tomorrow and post - it's truly amazing!"
Well, it's November, and once again I have to learn to live with the changing facial hair of my husband. I have to admit that I do like some facial hair on him; not that I wouldn't love him otherwise, but he just looks better with a clean cut beard/chin strap. However this month, he participates in the famous "No Shave November" and starts the month off clean shaven and ends it with a mountain man look. While it's not my "cup of tea", I have learned that there are some things not worth fussing over. Sure, would I prefer it if he kept the look from our engagement pictures or wedding day? Yes. But hair grows/can be shaved. And so, I let him have his fun :) To all those participating in No Shave November- may the best beard win! Here is a before picture of my handsome hubby that was taken on November 1st at work. I will be sure to post a picture when the month up so you can see the change.
I remember the day well. I was a junior in high school and had been contemplating "what do I want to do with my life?" I walked into a hospital with some of my cheerleading companions. Our cheerleading coach had to have all her female organs taken out and we were going to visit her. In that moment I felt like "this is where I belong". I never thought about being anything else inside the hospital but a nurse/nurse practitioner. My one main thought was "I want to be to other families what those nurses have been to my family as we've watched far too many of our loved ones battle cancer." I proudly proclaimed at my senior sports banquet "I am going to be a nurse practitioner".
It didn't take long for that bubble to get popped. Taking microbiology as a first semester freshman wasn't my brightest idea. I had always worked hard in school, but no matter how much I studied, I didn't know how to study for me. So I left my freshman year of college defeated. I had a 2.5 GPA and an adviser telling me I was never going to make it in the nursing world. Ever. My heart had one passion at the point, to be a nurse. So I made the decision to transfer to another campus of the school I was going to that required a lower GPA.
While it was incredibly hard to leave the main IU campus, I would never take back that decision for multiple reasons. At IUPUI I had teachers who invested in me and helped me learn how to study. I am not a quick learner. I have to spend hours studying to get average grades. But I love the sciences. I love the human body and I love anything that can help me take care of another human being. It was here I fell in love with exercise science. It was a long battle though, because my only thought still was "I want to be a nurse". At the end of first semester of Junior year I finally claimed exercise science as my major. I knew it was what God was asking of me, but I still struggled with it. It wasn't that I didn't love exercise science, in fact to this day it is something I am extremely passionate about, but it wasn't my dream.
My senior year I was able to go back to the main IU campus, and because of that I ended up some how by God's grace graduating on time. I knew nursing still was not where I was supposed to go next, but it still burned on my heart. I went off to the east coast to pursue my masters in nutrition. I love nutrition. I love what it can do in the human body. I loved learning the biochemical breakdown of the body. But as much as I love nutrition, my heart still ached. I wanted to be a nurse.
It is funny though, because the moment I felt like it was okay to pursue nursing. I didn't want to. Not because I didn't want to be a nurse, but I was deathly afraid that everyone was right. That I would never make it. I apply to one school in NYC and got rejected. I wanted to stop there. But I felt the nudge to go on. God knew the perfect school and the perfect semester for me. All the details He worked out I won't bore you with, but I will say this. I was in nursing school with the exact right people, at the exact right time, in the exact right school.
When I started nursing school I had already lost 2 grandparents and 1 uncle to cancer. 3 weeks into nursing school I spoke with my grandpa for the last time as he lost his battle to cancer. I remember his last words as he was dying 600 miles away from where I was "I believe in what you are doing you were created to be a nurse." The next morning I sat sobbing on the bathroom floor of my nursing school as I received the news he had taken his final breath. And I knew no matter how hard school was, there was purpose behind what I was doing.
Nursing school sucked. It was hard. I had no life. But I loved what I was learning. And I absolutely love where it has brought me. The interview process I'll save for another time, but I can tell you this, the wait was worth it. The hard times were worth it. And I know without a doubt I was meant to be a nurse. My nursing career and education aren't complete, I still have more schooling and many more steps to thank. But I'm thankful for the journey I started taking as a junior in high school. I'm thankful for where I am today because of all the trials I've been through to get here. Who knew the girl with the 2.5 GPA my freshman year of college would graduate nursing school with honors? God writes pretty cool stories, and thankfully because of His path I have 2 other careers I am passionate about as well.
"A stitch in time saves nine" is a common phrase known by the majority of people today. The idea of doing something simple now, rather than dealing with a bigger problem in the future applies to many situations. When it comes to your health, regular screenings can save you a world of trouble down the road. To all the women reading this, I have a request for you. I have a request that I hope you will take seriously. I have a request that I hope you will incorporate into your life and encourage women around you to follow suit.
You heard me. FEEL YOUR BOOBIES. EVERY MONTH! Regular self breast exams are very important to help detect cancer. While they are not 100% accurate(as many lumps are benign), they greatly assist in early detection. The National Breast Cancer Foundation, Inc. has a very informative section on their website(click on the link) that walks you through a self-exam, so be sure to check it out! Yearly mammograms and clinical examinations are also very important in detection as mammograms can pick up on cancer before you can even feel a lump. However, the self breast exam is still something that every woman needs to incorporate into her routine so as to catch lumps early. While breast cancer is not as prevantable as, say, lung cancer, it is a cancer that can be easily treated if caught early. Any cancer that goes undetected for a long period of time has a high chance of being terminal, so these self exams are very important especially if breast cancer runs in your family. So play it safe; feel yours boobies and stay one step ahead of cancer. -Ruth P.S. Check out my Breast Cancer awareness quilt in my etsy shop!
I have to admit that I feel like the world doesn't have a complete understanding of how bad this disease still can be. Thankfully, because of research and screenings many women can battle this disease and still have a long healthy life, but that isn't the case for everyone.
I was a new grad and I had yet to see a breast cancer diagnosis when I opened the chart, but I can remember you, my first breast cancer patient. You were a young women in your 30's and your disease was everywhere. You were in severe pain from bone mets and my heart broke for you. All you did was stand on your leg to go to the bathroom and it cracked in half because of disease eating away at your bones. It was there in your room as you cried out in pain that I, a new grad nurse, learned a new side of breast cancer, the side that is not often seen, the side that needs to be spoken about.
As I continued my inpatient journey I continued to meet you. Some of you were paralyzed and your life was forever changed due to your mets. Some of you had infection due to tumors. Some of you I met at the end of your battle as you took your last breaths on this earth. You have all impacted me.
At this stage in my career I am walking with you as your chemo nurse. My eyes are opened more than ever to how horrible this disease can be. Breast cancer patient you are that 1 out of 8 women diagnosed with breast cancer. You have the cancer that is most commonly diagnosed in women. You unfortunately have been handed the disease that is the 2nd leading cause of death of women.
I've changed your dressings from your tumor that is bursting through your skin. I've comforted you as your pain is so severe because of the cancer eating away the skin on your chest. I remember that time when I had to send you to get a stat CT because we were afraid you had a pulmonary embolism, but in the end it was the sad news that the cancer had spread to your lungs and there was a large amount of fluid build up. I'm seeing more sides of your disease every week, and they are ugly.
Breast cancer patient, you amaze me. As you are crying in pain, hating the fact that you have to take oxy to keep your pain at bay, you still smile at me and say to me "my nursey". You sit with me and look at pictures of my niece and nephew and tell me about all the things your beautiful young kids are doing. You are my hero. I learn a whole new side of what love looks like from you and your husband. The look he has in his eyes is one of the deepest of love I have ever seen. The way you and he work as a team and know each other so well is incredible.
Breast cancer patient, don't lose your spunk. Keep wearing your crazy hats, keep rocking that G.I. Jane look, and don't you ever lose your ability to look at the bright side. But know this, it is perfectly ok to have bad days. It is perfectly ok to be in a funk. It is more than fine if you need to cry your eyes out during each chemo treatment. Know this, that through every good news I will rejoice with you, through every bad news I will cry with you, and throughout the days of my life, I will fight this battle alongside you and fight for a cure for this disease. Thank you for blessing my life breast cancer patient. Thank YOU for fighting with grace and passion. Thank you for being you.
My goal as nurse has always included pediatric oncology. While I have not worked with anyone younger than 18 with cancer, pediatric cancer is still a strong passion of mine. September marks the time for pediatric cancer awareness. This week I'm so excited to focus on educating each of you about pediatric cancer. There are many ways to support research for pediatric cancer and support those children and their families who are walking through this battle. Below is a video that outlines the basics of pediatric cancer facts and figures currently.
Very little progress has been made in research and proper treatment. Statistics don't tell the whole story. We have such a long way to go and I'm hoping through the blogs this week, each of you will be made more aware of how deep the need is in the pediatric cancer world. Cancer is the leading disease cause of death in children ages 1-14.
Alex's Lemonade Stand is one of the ways you can start to make a difference. Continue to read the blogs this week and videos posted to educate yourselves.
It was with you that I got to start my nursing career. It was your cancer that I first got to know at an in depth view. I was there with you has you came back from your TAH/BSO and whatever else they felt needed to be done. As you rolled up to the floor from the PACU in so much pain I was immediately running to get pain meds. I was there with you as you could barely keep your eyes open from the pain medication but you were also anxiously waiting to see what the doctors found in your abdomen. I was there with you holding your hand as the doctors told you it was cancer. I was there holding your hand as we rejoiced over the news it hadn't spread. I was also there holding your hand as you were told it had spread farther than they had thought. I was the one annoyingly asking you to sit on the side of your bed when the thought of even lifting your hand was terrifying. Because a nursing manager took a chance on me as a new grad, I was there in your world... walking with you... and learning about how hard a diagnosis of ovarian cancer is.
At a very young age cancer was part of my vocabulary. Before I was even born my paternal grandma battled ovarian cancer and lost. It is such a rare diagnosis, and is so hard to detect.
I've been a few places since that first job. But I still walk with you. Now my job is to walk with you day in and day out as you deal with chemo. As you get your scans back. I'm still there holding your hand through good news and bad news. And I'm so thankful for the opportunity to walk with you through your battle. Thank you, ovarian cancer patient, for letting me walk with you. To learn so much about love, drive, and fight through your own battle. To learn what it means to have grace. To learn what it means to be hopeful in the hardest of situations.
It is for you I am writing this blog. To get the word out there about ovarian cancer. Together, let's fight this thing!
With greatest gratitude,
One of your nurses
Quick Facts and Figures:
* 1 in 72 Women will be diagnosed with ovarian cancer in her life (ovariancancer.org)
* It is the 5th leading cause of cancer deaths in women (ovariancancer.og)
* Most women are diagnosed in late stage which has a lower survival rate
This week, the world lost a very bright light to our mutual enemy, cancer.
Talia Castellano, a thirteen year-old girl, and YouTube sensation, had been battling cancer for over half her life. She used make-up as her wig, and her internet tutorials, some filmed from her hospital rooms, inspired millions of lives. Ellen Degeneres so admired this young girl's courage and determination that she started a campaign to have Talia made an honorary Cover Girl. Ellen succeeded, and Talia's face graced what will be some of the cosmetic company's most memorable advertisements.
Talia often said she would watch other YouTuber's videos to cheer her up, most notably those of Kandee Johnson. Kandee's warmth and joy radiate from her blogs and videos, and her tribute to Talia and her family was one of the most touching. See Kandee's tribute here.
Our hearts go out to Talia's mother, Desiree and her sister, Mattia. Though we feel the ache of loosing Talia, her life and her memory are blessings.
Each day in both my professional and personal life I get questions about exercise, cancer, and exercise post cancer and during active treatment. Not only does cancer change your body, but the surgery, chemo, and radiation you have change it as well. So where do you start after months or maybe even years of losing your normal work out routine? Where do you start if you've never had a work out routine? How do you deal with the neuropathy? How do you deal with the weakness of muscles? The lack of energy and motivation? How do you even start to have a somewhat normal life?
Cancer changes your whole body and one of the biggest side effects is exhaustion. A lot of times people feel defeated, especially when they were super active before the cancer. I'm here to tell you that it is perfectly OK to feel defeated. It is ok to be angry. And you know the perfect place to start getting back in an exercise routine? Start by expressing your feelings about the cancer and how it changed your life.
I could tell you all the benefits of exercise in this first post, but I won't. What I am going to tell you is two things.
1. Get out a journal and write down every feeling you have towards the cancer that overtook your body and changed your life and body forever. Be honest. Recognize the battles you are facing. Truly let your emotions out.
2. Start by taking a walk each day to start to process everything and get your body moving a little. I don't care if your walk is 3 minutes long. If you walked, it is a start.
Don't try and conquer the world in one day, this will be a process, but I promise you, the benefits will be with it!
Health and beauty is not all about vanity and self-absorption. It is about representing yourself in such a way that is respectable and truly reflects yourself. Women who have to go through radiation and chemotherapy may not understand the fullness of this treatment for cancer and the negative affect is has on their outward appearance. I believe we all take our hair and features for granted. We never fully realize their purpose or impact on us until they are gone.
Cancer is such an ugly and harsh word that is forever becoming a common reality for humans to learn to deal with and maneuver. Learning to fight, heal, and cope is a lot of this battle. Part of the coping does include allowing others to help get us back to a presentable comfortable self that we can look at in the mirror and say, "Yes, this is the new me...and although it is not the old me, I will embrace my new look!"
It might seem like a little thing--penciling in someone's vacant eyebrows, applying a fresh palate of colors to a seemingly peaked chemo drained face and helping find a wig of their liking--but, it makes a huge impact on our self-esteem and perception of self. This is not vanity as much as it is restoring a person's dignity. This is where the health and beauty field can assist in this healing and coping of such a disease.
Just how beautiful it is to help someone feel a little bit more comfortable in such a situation. I truly believe it will help them feel better in the short and long term.
Another very cool little find? The company, Ski and Livi, was established to empower women dealing with cancer through their very unique jewelry line. This might be something to consider if you know someone who has lost their hair or will be due to chemotherapy and radiation treatments. What is the uniqueness behind Sky and Livi? They create diamonds through a lock of hair.
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