Mental Health Screenings

                  In my last post I mentioned taking mental health screenings as a part of Mental Health Awareness Month. Today I would like to further discuss mental health screenings. What is a mental health screening? A mental health screening evaluates a person’s mental well-being using a standard set of questions to identify potential signs of mental health disorders. They are intended to provide for early detection. These screenings help health care providers understand a person’s mood, thinking, behavior, and memory. 

                  These screenings are usually questionnaires and can be given in a primary care provider’s office. The questionnaires include general mental health screenings, depression screenings, anxiety screenings, PTSD screenings, substance abuse screenings, and eating disorder screenings. The Patient Health Questionnaire (PHQ-9) is often used to screen for depression. Two other common screenings include the Generalized Anxiety Disorder Scale (GAD-7) and the Mood Disorder Questionnaire (MDQ). These screening tools allow the primary care provider or other provider to know if there are symptoms of a mental health disorder. When used regularly, for instance as part of a yearly physical exam, mental health concerns can be identified early. When identified early, mental health conditions often have better outcomes. 

                  These screenings are a valuable part of a yearly physical examination but should also be used if a person is exhibiting symptoms such as sadness or excessive worry. Screenings should also be used when there are major changes in personality or eating habits and if dramatic mood swings are present. A primary care provider can gain a better picture of a patient’s mental health by using one of these screenings.

                  Mental health screenings are also available online. Mental Health America offers online screening tools that an individual can take. If one of these tools indicate that you may be experiencing a mental health issue it is important that you share this information with your doctor or a therapist, who can provider further screening and evaluation. This can lead to treatment if necessary.  

When used as a part of a yearly physical it is important that the provider discuss the results with the patient. Too often providers see the results and just add it to the patient’s file. I would recommend that if you fill out a screening tool you ask the provider to review the results with you. This is important to ensure that the provider is not overlooking the screening tool. Unfortunately, I have experienced providers who overlook results. Luckily, in my case, I have mental health providers who are well aware of where my mental health is, and I don’t need to rely on a primary care provider for mental health care. But for many people the primary care provider is the only one they have who can catch any issues. So, do not be afraid to ask the provider for the results of any mental health screening you take. These tools are only useful if we review the results.

Being aware of the status of our mental health is vital to our well-being. We cannot take our mental health for granted. As with any health issue, early detection is crucial. If your primary care provider does not give you a mental health screening, ask for one. Take the initiative. Screenings make a major difference in mental health care. 

Mental Illness and Primary Care

      What happens when we deny our mental illness? The other day I had a conversation with my primary care provider, Cristina, that caused me to think about this. I always think about people with depression as not being listened to or taken seriously. Talking to Cristina I realized that the opposite could happen. A primary care provider can recognize the signs of depression and be met by resistance from the patient. What happens in that situation? It is not like the provider can use bloodwork or scans to show the patient that the depression exists. 

So, why would a person not want to hear that he or she has depression. The first thing that comes to my mind is stigma. Society doesn’t exactly make it easy to accept a mental health diagnosis. Often, we are taught to hide our emotions or tough it out. Mental illness is often joked about. People use mental health diagnoses in the wrong context. For example, someone who likes things neat and orderly might say they have OCD. That’s not OCD. I have a friend who suffers with OCD. I have seen her struggle. Believe me OCD is not just wanting things clean. It is much more involved and debilitating.  Unfortunately, it is a common perception in society that people with OCD are neat freaks. 

Likewise, depression is not just being sad. As I’ve discussed many times on this blog, depression is much more than being sad. There is a sense of hopelessness.  Often, people with depression fight a desire to escape life.  Depression is so much more than a passing sadness. I recently heard someone say, “I am so depressed. My favorite restaurant is closing.”  Trust me. That is not depression.  Depression is all-encompassing.  It affects every aspect of a person’s life. The word depression is used too casually, and it leads to a lack of understanding.  

Unfortunately, mental illnesses are often trivialized and misunderstood. It makes sense that some people would resist a mental health diagnosis. Who wants to be labeled with an illness that is misunderstood and even mocked?

Back to the primary care provider. They are often the first health care provider to recognize a mental illness. I don’t know the statistics, but I have read that primary care providers prescribe a significant amount of anti-depressant medications that are prescribed in the United States.  I am not an expert.  So, I don’t want to cite numbers or pass judgement on this.  However, it seems to me that if primary care providers are that involved in treating mental illness, we need to give them more education and support.   

How do primary care providers assist their patients in navigating their illness?  They are important in recognizing the signs of a mental illness.  Often, they use a paper and pencil screening tool to gauge how their patients are doing mentally.  They pick up on signs by talking to their patients.  Symptoms of depression sometimes surface as physical complaints.  These can include aches and pains, fatigue, sleep disturbances, gastrointestinal issues, and changes in appetite to name a few.  An astute primary care provider will investigate mental health causes along with looking at physical reasons for the symptoms.  This provider treats the whole patient.  He or she understands that there are many facets to a patient’s health.

Often, when a person is depressed, he or she feels alone. There is a darkness surrounding them. Life may seem hopeless. It is hard to talk about these feelings with others. You believe you are alone and that no one else understands. Reaching out for help is difficult, sometimes impossible. Add to this being aware of the stigma surrounding depression. It is possible for a person to go into denial and refuse to acknowledge the depression is impacting him or her. When someone else brings it up, even a primary care provider, different things can happen. The person may experience a sense of relief that there is a reason for how he or she is feeling. This is the person who will accept the diagnosis. He or she is more likely to accept therapy and/or medication. On the other hand, the person may go into denial. He or she knows something is not right but doesn’t believe it can be depression. This is the person who refuses therapy and medication. 

A doctor can’t force treatment on a person.  The patient in denial is likely to continue struggling. This is a tragic in a time when there are so many treatments for depression such as therapy, support groups, medication, TMS (transcranial magnetic stimulation), and ketamine. The provider can encourage the patient to accept treatment, but the patient needs to be willing to accept that treatment.  I would imagine it would be frustrating for the provider to recognize a mental illness, such as depression, and not be able to provide treatment.  

I believe we need to have more conversations about mental health.  Being open and honest about mental health is the only way we are going address this issue.  The stigma surrounding mental health needs to be significantly reduced.  Doctors, physician’s assistants, and nurse practitioners need to be able to address mental health openly.  This will allow them to start treatment and refer people to specialists.  People with mental illness deserve to be treated by psychiatrists, psychologists, and therapists.  The primary care provider is the link to these specialists.  That is why their role is so important. 

When a patient refuses to accept a mental health diagnosis he or she is refusing the treatment that can help.  I know from a lifetime of experience that treatment is vital to living with depression and anxiety.  The same is true of any mental health disorder. As a society we need to work to give primary care providers the education and support they need to address mental health issues.  We need to spread awareness of mental illness.  Hopefully, this will help people be more open to accepting a mental health diagnosis.  Supporting organizations like NAMI, (National Alliance on Mental Illness) is an important way to spread awareness and eliminate stigma.  

Continue following my blog.  I hope to address this issue in more depth in future posts.  

 

 

 

 

 

Turning Hurtful Words into Healing

           I am very open about my mental health, but I wasn’t always this open.  I used to hide my mental illness in shame.  I didn’t think others would understand. It took hurtful words from a health care provider to make me realize that I shouldn’t be ashamed of my mental illness.  In fact, my experience with this health care provider made me realize that it was time for me to use my voice to help myself and others who struggle with mental illness. 

            The story of how this health care provider hurt me is in my memoir, “Traveling the Healing Journey: Finding the Light in Mental Illness”.  I am going to share it here, too, because it was an instrumental event in my journey.  In my book I refer to this health care provider as E.  I will do so here as well.  I could use her name, but in my heart, I have forgiven her.  Actually, as you will see, I may owe her a debt of gratitude.  

            In 2017 I had to change primary care providers.  The one I had been comfortable with left the clinic I was going to.  Before she left, she recommended that I see E for my health care needs.  She told me that I could trust her and that she was a good provider.  I was hesitant, but I made the change.  The first visit I had with her was okay, uneventful.  It was the next time I saw her that I had a terrible experience.

            I saw E for my yearly physical.  I always get a little anxious when I have medical appointments, but I was doing fairly well when I went into the exam room.  The appointment started okay.  There is a part of the annual physical exam that I have never been able to have completed because of my anxiety, but providers have always tried.  Usually, I would take something to relax me before starting and the provider would do their best to calmly talk me through it.  I was never able to get through that part of the exam, but no harm was ever done.  The provider just moved on to the next part.  When it came time for that part of the exam E read my records and said she wouldn’t do it.  She said I had to go somewhere else for it.  I tried to tell her I wanted her to do it and that I had already taken medicine to get me through it.  She looked straight at me and said, “No.  You are a liability.” I couldn’t understand what she had said.  Why was she calling me a liability?  I felt like there was something wrong with me.  She was blaming me for something that was caused by my anxiety.  I froze.  I didn’t know what to say.  I know I had tears in my eyes, but she just ignored me.  She moved on to the next part of the exam.

            She told me to lie down so she could examine my breasts.  In my head thoughts were swirling.  What was wrong with me? Why can’t I be like other women?  Then I realized she was about to touch me.  Knowing I often get jumpy when I am touched, I wanted to warn her so she wouldn’t think she was hurting me.  I said, “Sometimes I jump when I am touched, but it doesn’t hurt.”  E looked at me and said in a way that sounded very sarcastic to me, “I can’t examine you, if I can’t touch you.” I wanted to run out of the exam room.  I needed to get away, but I was trapped. Somehow, I managed to let her finish the exam.  I couldn’t get to my car fast enough.  Once safely away from her and in my car, I broke down in tears.  

            Was my anxiety my fault?  Depression and anxiety have been a part of my life for as long as I can remember.  No health care provider had ever made an issue about the way E had.  I couldn’t get her words out of my head.  “You are a liability,” kept echoing in my mind. 

            As soon as I talked to my psychologist, Dr. Klein, I told him what happened.  I cried as I told him.  It was obvious how much those words had hurt me.  He tried to reassure me that I was not a liability, and that E was wrong for saying it.  I just couldn’t get those words out of my head.  It took two weeks for Dr. Klein to convince me to speak up.  I had received one of those feedback emails from E’s office.  I wrote that I had a really bad experience and that I was never going back.  I didn’t explain what had happened.  I just said I was never going back because of my last appointment.  

The next day I received a call from a woman in the office.  I don’t remember her name or title.  She asked me why I didn’t want to go back.  I told her what E had said and that it was very hurtful.  She apologized.  She said it sounded like an issue of poor word choice.  At that time, I wasn’t at a point where I could explain how E had hurt me and how it was issue of her mistreating me because of my mental illness, not just poor word choice. The woman was kind.  She told me that she would like me to continue going to this office and that I could see someone else moving forward.  I was hesitant.  She recommended a physician’s assistant, named Greta.  She promised me that Greta was different.  She said she was kind and understanding and assured me that I would like her.  I was overwhelmed with the whole situation and really didn’t want to go through the process of finding a new primary care provider.  So, I agreed.  The woman told me she would tell the doctor in charge about my experience.  

I never received an apology from E.  I never saw her again.  There was no acknowledgement of how she had hurt me because of my mental illness.  Soon my hurt turned to anger.  I spent a lot of time discussing my feelings surrounding this incident with Dr. Klein.  I didn’t understand how it was okay for a health care provider to not only dismiss my mental illness but insult me over it.  E made it seem like my anxiety was my fault.  I wondered how many other people she had done that to.  Was it common for her to be flippant with patients with mental illness or was I her only target?  I started thinking more about the effect her words had on me.  With Dr. Klein’s help I realized I hadn’t done anything wrong.  My anxiety wasn’t my fault.  I have an illness and a primary care provider should be understanding of mental illness. 

It is at this point that I realized I couldn’t sit back and allow myself to be treated that way.  I had to stand up for myself.  This experience led me into mental health advocacy.  I finally understood that I had a voice, and I could use it to stand up for myself and others with mental illness.  I began looking for mental health organizations.  My writing became focused on mental illness.  I stopped hiding my depression and anxiety.  I began speaking about mental illness. I learned to tell my story and looked for opportunities to share it.

Hurtful words led me into mental health advocacy.  For that I am grateful.  The work I have been able to do since that day allows me to forgive E.  I will never forget, but I have forgiven.  Her words echo in my head like a rallying cry urging me to use my voice to fight the stigma surrounding mental illness.

The primary care providers I have had since that terrible experience, Greta and Cristina, have shown me that not only can a primary care provider understand the needs of a patient with mental illness, but they also need to be able to understand.  I am grateful that I found providers who care and understand.  

I hope through my advocacy work more health care providers learn about mental illness and how to treat patients.  Mental illness is an illness.  It is no more the patient’s fault than a cancer diagnosis.  My goal is to use my experience to educate others.  I want my experience to serve a purpose.  If you are health care provider, I urge you to learn more about mental illness and how to understand your patients.  If you have a mental illness, I urge you to remember that you have an illness and you do not need to be ashamed of it.  

Sometimes I think I would like the opportunity to speak to E.  I know it has been several years and she likely doesn’t remember her hurtful words.  I would just like to explain how she hurt me and let her know that those words changed me.  Her hurtful words led me into mental health advocacy.  I now have a voice that I will continue to use to help myself and others.  Fortunately, her hurtful words led to good.  So, if you’re out there, E, thank you for giving me a reason to find my voice.

 

            

Celebrating Nurse Practitioner Week

            Last month I recognized special physician’s assistants.  This week (November 12-18) is National Nurse Practitioner Week.  I’d like to recognize these amazing health care workers.  

            First, let’s learn a little about these professionals.  According to the American Association of Nurse Practitioners, nurse practitioners are “…clinicians who assess, diagnose and treat acute and chronic diseases, as well as counsel, coordinate care, and educate patients regarding illnesses.”  They “…undergo rigorous national certification, periodic peer review, clinical outcome evaluations, and adhere to a code for ethical practices.”

            Nurse practitioners treat patients in clinic and hospital settings.  They work with patients in a variety of health care fields including family practice, acute care, oncology, pediatric care, psychiatric/mental health care. These are just a few of the fields where nurse practitioners can be found.

            I was first introduced to the care of a nurse practitioner 20-25 years ago when I saw Tam.  She was incredible.  She took care of me with the knowledge of a doctor and the bedside manner of a nurse.  She took great care of me in the years that I saw her.  Tam was one of the first primary care providers to address my mental health.  I was very grateful for her care.  I am still in contact with Tam after all these years.  Occasionally I ask her for medical advice.  She has always been there.  I consider myself lucky to have been treated by Tam.

            Right now, there is an important nurse practitioner who is a part of my care team.  You have met her on this blog.  Stephanie is a psychiatric nurse practitioner who provides the TMS and ketamine treatment that have been so integral in my mental health care.  When I first started TMS a psychiatrist provided oversight of my treatment.  The second provider was Dr. Hutton, a leader in the field.  They were both great.  When Stephanie took over, I experienced the benefits of a nurse practitioner.  Stephanie ensures that I am comfortable with my treatment.  She has monitored the ups and downs I have experienced.  She connects with my psychiatrist, psychologist, and primary care.  In fact, she has been a leader in that connection.  When I talk to her about my mental health she listens intently and helps me make sense of what my depression and anxiety are doing to me.  Stephanie is there during the crises. She has helped me through suicidal thoughts and provided me with hope.  I feel comfortable with Stephanie and know that I can share any thoughts with her.  I appreciate Stephanie greatly.

            As a person with mental illness, I understand how important it is to have a mental health team.  Stephanie is an integral part of my team. I realize a lot of people don’t have a mental health team like I do.  I am aware that I am lucky.  I spent years without a team.  It is my hope that there will be more teams of mental health care providers to treat people with mental illness.  Psychiatric nurse practitioners are an important part of building those teams.  I hope someone reading this will decide to become a nurse practitioner after reading about them.  We need more nurse practitioners in the health care.

            Before I end this post, I’d like to give a shout out to another nurse practitioner.  Thank you, Jackie. She is the nurse practitioner who is a part of my oncology team.  Your care is appreciated.  

            If you see a nurse practitioner show your appreciation this week.  Show them your appreciation whenever you get the opportunity.  Encourage young people to consider a career as a nurse practitioner. Thank you to all the nurse practitioners serving patients. 

 

I Could Only Laugh

            Recently, I wrote about my frustration with the health care system.  I had an experience last week that exemplifies the problems in the health care system.  It was so ridiculous that I couldn’t help but laugh.  

            You may remember that I had to fight to get care from the oncologist who is currently providing my care.  The first doctor, Dr. M, just wasn’t the right doctor for me.  I felt like the level of care was lacking.  The last time I had any contact with that doctor, or anyone in his practice was on August 14^th.  Remember that date.  I switched to Dr. St who has been providing my care and chemo since then.  Well, the other day I was laying down talking on the phone to my friend, Pam, after my chemo treatment.  Another call blinked on my phone screen.  The caller ID said it was from the first oncologist’s office.  After a moment’s hesitation, I answered it.  The man on the line said he was calling because Dr. M’s office was having difficulty getting my insurance company to authorize a blood draw.  I had to pause before I could respond.  What was he talking about?  It was October 4^th.  Remember I hadn’t had contact with this doctor or his office since August 14^th.  I had canceled a chemo appointment and an appointment with the doctor.  So, I told the man that I was no longer being treated by Dr. M because I had decided to go with a different doctor.  I pointed out that I had told someone in his office that I had changed doctors a few weeks prior.  The guy seemed clueless.  He asked me which doctor I had switched to.  My first thought was that he didn’t need to know.  Then I decided that I would tell him so Dr. M would know there were better doctors out there.  

            This whole situation left me laughing.  Where the hell did they think I had been for the last seven weeks?  I have stage 4 cancer.  Did they think I would just miss appointments?  Did they even notice that I hadn’t been there?  This proves that I made the right decision when I switched to Dr. St.  If a doctor lets a patient with stage 4 go missing for seven weeks, is he really interested in healing the patient?  Was anyone in his office really paying attention? 

            I understand that doctors have a lot of patients, and they depend on their staff who don’t always tell them everything.  This is ridiculous, though.  I made the right decision to go with Dr. St. 

            Health care baffles me.  There are good doctors out there.  Some are prevented from providing care the way they want because of the system and insurance companies.  Another example happened on Tuesday.  My psychiatrist made a change to how I take a medication, which required two different doses of the medication.  When I went to the pharmacy, they would only give me one.  I was told that I had to wait until the next day for the other one because my insurance said that is when it was due to be processed.  Never mind that my psychiatrist had made the decision to make the changes based on my health needs.  Evidently, the insurance company knows better than a psychiatrist!  I am frustrated.  Adding to the frustration was the fact that it was 4:00 in the afternoon.  Does it really make a difference if I pick the prescription up then as opposed to 9:00 the next morning.  Just an inconvenience for me.  

            Check back on Monday for a new post.  I am not sure what I will write about.  Perhaps another poem.  I have two poems that I have written during chemo treatment.  There is also a guest post on TMS treatment coming soon.   I wrote a lot in my journal yesterday.  Maybe there is a post in what I wrote.  Some of it is about the mental side of facing cancer.  Don’t miss Monday’s post. 

 

 

National Physician’s Assistants Day

           I’d like to do something a little different today.  October 6th is a day set aside to recognize an important group of health care professionals, physician’s assistants (PA).  Since I am a teacher, I need to start with a little history lesson.  

The physician’s assistant profession was created by Dr. Eugene Stead at Duke University in 1965.  Two years later on October 6, 1967, the first class of physician’s assistants graduated and joined the health care profession.  You may be wondering what exactly a physician’s assistant is. A physician’s assistant is a health care professional who is licensed to practice medicine as a part of a team with physicians.  They conduct physical exams, diagnose and treat illnesses, order and interpret tests, prescribe medication, counsel on preventive health, and may assist in surgery.  Physician assistants are valuable members of the health care profession.

I chose to write about physician’s assistants today because I have received great care from physician assistants over the years.  One of the first I met was Mona.  She played a significant role in my life because she caught that a former psychiatrist was overmedicating me and that I was addicted to one of my anxiety medications.  I am grateful to her for being willing to address a problem and help me get the right care.  

After Mona I had a bad experience with a health care professional, but that is a story for another post.  This experience left me unwilling to trust health care professionals and convinced that my mental illness was a negative issue for health care professionals.  Luckily, I soon met another physician’s assistant, Greta.  She was kind and understanding.  She made it possible for me to let go of my insecurity and fear so that I could trust a health care professional again.  I only saw Greta for a couple years, but she impacted me.  She took an interest in my health care and made me feel safe.  She was always proactive.  Greta understood when I was depressed or anxious.  She gave me the time I needed and was always empathetic.  I am grateful to Greta for the impact she had on me. 

Greta moved on, but before she left, she recommended another PA to take over my care.  I was nervous.  I wasn’t sure I could see someone other than Greta.  My first experience with Cristina was a positive one despite my fears.  I saw her because my insurance insisted on a referral from my primary care to get the treatment I needed for my depression.  I sat in the exam room and meekly expressed to Cristina that I need her to refer me for transcranial magnetic stimulation, also known as TMS. (A post on TMS is forthcoming.) I was aware that Cristina didn’t know about my history with depression.  I was worried she would ask too many questions and that she wouldn’t make the referral.  Greta was right.  Cristina was so understanding.  She made the referral without questioning me.  She was empathetic and understanding.  I knew in that moment that I was safe with her.  I have been seeing Cristina for several years now.  I trust her.  She takes time with me.  She talks with me.  One thing Cristina does that I think is sign of a high-quality health care professional is she listens to me, but not only what I am saying, but also what I am not saying.  Being able to do that requires a gift.  Sometimes I think doctors move so fast and have so much to do that they forget to connect with patients on personal level.  My experience has been that physician’s assistants, like Cristina, meet patients on a personal level and provide care from there.

The past couple of months I have seen Cristina several times.  Having her by my side has been extremely important.  She has helped me through my cancer diagnosis.  I saw her after I was dismissed by the ER.  She looked at the ultrasound results and didn’t hesitate to order tests.  A doctor had overlooked my test results in the hospital, but a physician’s assistant knew more was needed.  I had tests done and spent a few days in the hospital.  Cristina could have let the hospital take over.  There was a doctor there, although I don’t even remember his name.  When he would speak to me, he would spend about three minutes with me and speak over my head.  Cristina took over. On July 21^st she gave me the news that I had cancer.  It was so much better to receive this news from her instead of a nameless, three-minute doctor in the hospital.  She allowed me to process what she was saying in my own way.  She was empathetic and caring.  In this day where masks prevent us from seeing each other’s facial expressions, I could see how much she cared in her eyes.  Seeing that look made this devasting news easier to cope with for me.  She continues to be by my side in this battle.  She helped me get the right oncologist, someone who is more like Cristina than like Dr. Three-Minute.  I know that Cristina is there if I have questions or if an issue arises.  That is an enormous comfort, one that I am grateful for. 

I am sure there are good doctors out there.  There are doctors who provide the same kind of care I have received from Cristina.  I am grateful to have had physician’s assistants as my primary health care providers over the years.  I believe their care is on a different level.  Maybe it is their training.  Maybe it is the type of person who goes into this profession. It is also possible that I have just been lucky.  Whatever it is, I am grateful there are physician’s assistants in the health care profession.  That is why I share this post today.  I want to acknowledge physician’s assistants, especially the ones who like Cristina provide care with their heart as well as their wealth of medical knowledge.  

If you see a physician’s assistant for your health care, please take a moment to acknowledge them and say thank you.  October 6^th is National Physician’s Day.  It is followed by Physician’s Assistants week, October 6-12^th.  

The Importance of Relationships in Mental and Physical Illness

            For most of my life quality relationships have eluded me.  The depression kept my relationship on a surface level.  I don’t think I have ever had a deep relationship.  Most of that is my fault.  I resisted having relationships out of fear that my depression would get in the way.  I didn’t want to bring the darkness of depression into someone else’s life.  It is one of my regrets in life. Unfortunately, it is a part of mental illness. Many of us experience difficulty with relationships.  Many of us hide from those who could support us.  

            Now that I have a physical illness, breast cancer, and I am experiencing the importance of relationships.  It makes me realize all that I have missed because of my depression.  So, I would like to explore the importance of relationships in dealing with any illness. 

            I always thought I was alone.  I battled depression alone except for my mental health team.  Dr. K, Dr. S, and S have been by my side.  Even though it is their job they have always supported me. I know how important that is.  It makes a difference.  Unfortunately, as valuable as it is to have them it is not enough.  They are the only ones who really understand what I was going through.  They are the only ones I can explain things to and not feel like a fool.  They are still with me as cancer has been added to my battle.  I know they are on the journey with me for the long haul and I appreciate that immensely.  

            Cancer has brought others to my journey.  It is overwhelming, in a good way, how many people are supporting me.  Relationships I didn’t realize I had have emerged as stronger than I could have imagined. People are offering to help.  People ask how I am doing, make sure I have everything I need.  Cancer is a different illness than depression.  People are more familiar with seriousness and deadliness of cancer in a way they are not about depression.  I am grateful to have the support and the emerging relationships. Let me share a bit about some of them.  I won’t be able to mention everyone.  This post would go on too long and I’d lose your interest, but I want to highlight a few.

            I think relationships come in different types.  There are familial relationships, friendships, acquaintances, and care providers.  I have experienced a growth in all four.  

            I’ll start with family.  My mother, K, has been supportive while battling her own cancer and other illnesses.  She lives a couple hours away and is not able to visit, but she checks on me every day.  Whenever I mention a problem, something arrives from Amazon the next day to help.  My hair being on everything was driving me nuts.  I told her and the next day lint brushes were at my doorstep.

            My Aunt Holly, who you met in my hair funeral post, has been by my side through all the medical appointments and has taken care of me after treatments.  She has been wonderful.  She is such a caring person and an amazing resource.  I am so grateful to have her fighting with me.

            My cousin, S, has helped me with all the insurance battles and other technical aspects like my advanced directive.  She has been there to love me and let me know that I am loved.  We’ve walked on the beach, which was peaceful.  My cousin, N, checks on me via text several times a week.  I am grateful for his messages. 

            My brother, T, has stepped forward in a way I didn’t expect.  I didn’t know where I stood with him.  I don’t think we’ve ever been close.  He has a family and a life to live, but he has been very supportive and caring.  He was there when I received the diagnosis.  I wasn’t expecting him until later that morning, but when I walked out of my primary’s office, he was waiting in the parking lot.  That meant a lot.  Last week when I told him I was struggling with the hair loss, he took off his baseball hat and gave it to me.  I had to fight back tears.  It was a welcomed gestured.

            My aunt, C, came down from the Sacramento area to stay with me and help me.  I was grateful for her presence.  She did a lot for me. It’s hard to need so much help, but I know I need it right now.  She plans on coming back.  That is comforting to know. 

            Friends have been wonderful.  I have too many to mention all of them here. I appreciate S sharing her own experiences with cancer with me.  She is someone I can just talked to openly about the cancer.  I rely on that.  Sh and C have supported me with visits and help with necessities.  M and J check on me.  M is leading the way with updating colleagues from the school I just left.  Those colleagues have been great.  Many have reached out.  M is organizing a way for them to help me.  I am grateful for this.  I thought I was just another teacher, but my colleagues care about me.  I cherish their care. 

            SR keeps me going with her messages and inspiration.  I miss hanging out with her and listening to music.  

            P is my rock.  Talking to her makes me feel more positive in this battle.  I know it must be difficult for her to see me going through this after losing C to cancer.  Yet, she is supporting me and knows just what to say to make me feel better. 

            People I went to elementary school and high school have reached out.  It’s amazing that people from so long ago are reaching out.  Social media allows those types of relationships to exist.  It lets me know that people care about me even if we haven’t seen each other in decades.

            Relationships with medical providers is also an important aspect of the battle with illness.  They play a crucial role and how a person relates to them is important.  I’ve already mentioned my psych team.  My primary care, C, has been great.  When the signs of a problem first emerged, she didn’t hesitate to act.  She made sure she was the one who gave me the diagnosis.  That was vitally important to me.  I couldn’t have handled hearing it from someone else.  Her support has been important.  She is there for me when I need her.  I think that is what a primary care provider is supposed to do.  They need to understand their patients and be the conduit to other providers.  C has been that and more.  Her nurse, H, has been immensely supportive.  I am grateful to her for being supportive and making sure I have access to everything I need.

            I had to fight to get care at the facility I am at now.  I am so grateful that I fought.  My oncologist, Dr. St, is amazing.  She is understanding and supportive.  She explains everything clearly and doesn’t mind repeating when I don’t comprehend.  Being in her care is going to make a difference because she understands that the relationship is just as important as the treatment she provides.  Her nurse, C, is someone I feel really connected to.  She makes me smile and she understands firsthand what I am going through.  Her little dances remind me that I can beat this cancer.  The whole staff in Dr. St’s office provides relationship-based care.  They make me feel safe and provide top-notch care.

            A couple people have even shared their cancer stories in the comments on this blog.  Those made me realize I am not alone.  Thank you for sharing.  

            I share these relationships to remind readers that there are more relationships in our lives than we realize.  People do care.  It took a serious illness for me to realize it.  I wish I had made this realization without cancer.  Unfortunately, cancer is the hand I’ve been dealt.  With the relationships that have emerged in my life, I am going to be able to fight.  I am not alone.  There is no way I can fight cancer alone.  It is scary and overwhelming.  I need the relationships to help me battle.  Thank you to all who are by my side.  You are appreciated more than you know.

            Check back next week.  I intend to write about some of the issues I see in the health care system and offer my thoughts on what can be done.