Serious illness – the trauma of diagnosis and treatment

As you deal with both caregiver and loved ones, remember that your presence can be an enormous gift to everyone.

By BATYA L. LUDMAN
My niece, a nurse, was recently diagnosed with metastatic colon cancer. She is 30 years old and the mother of a young baby. She was completely asymptomatic and it was totally by chance that this was picked up. For those who actually have symptoms that concern them, even if they seem like “nothing,” you owe it to yourself and your family to get things checked out. This may lead to early detection (which just might save your life), decrease stress or serve to put your mind at ease, as more often than not it indeed proves to be nothing serious.
That said, when a family member or friend has been diagnosed with a serious illness, the emotional impact on both the individual and those close to them can be enormous.
Cancer, for example, is a frightening word.
One can’t help but immediately imagine the worst-case scenario, and these thoughts and negative images remain with those involved 24/7. One goes to bed with them, wakes with them and is haunted by them during the night when he awakens and can’t get back to sleep. The early days around diagnosis can be stressful beyond words. Time seems to drag on forever between diagnosis and treatment and the “what if’s” often take over.
How one copes with the initial diagnosis depends on, among other things, personality, coping style, perception of the illness and support from others. Diagnosis has several phases, and as one travels through the initial period of shock, disbelief and eventual adjustment, the journey is rarely smooth. With this roller-coaster ride comes grief for what was, what could be and what isn’t.There is a period of anxiety, fear and even depression that may wax and wane as a treatment plan gradually unfolds.
Support is essential to both patient and caregiver, and there are many ways that friends and family can help to make the initial process more manageable. Here are just a few suggestions: Take your lead from your loved one. Some people like to be active participants in deciding their care, while others prefer to be uninvolved.
Some are secretive, and others want support from anyone and everyone. Some people like to talk about the situation and need to go over things in great detail, while others need to push things to the back of their minds for as long as they can. There is no one best way to cope. This is very much an individual thing, and it is only when one is not coping that you need to be concerned.
Your job is to be there and to simply listen.
People may want to talk for short periods of time, may have lots to say and may waver between these two. This is all a very normal part of the grieving process, and it can be totally absorbing. Keep from giving your thoughts and opinions unless asked.
Encourage routine as much as possible.

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Routine provides everyone with a sense of stability when there are so many unanswered questions and it is hard to plan or predict. This is especially true for families who can benefit from some regularity around eating and sleeping and other schedules that involve young children.
Plan for uncertainty. Recognize that your loved one may have rapid mood swings, fatigue, anxiety, difficulty focusing and many other signs of normal adjustment to a very abnormal situation. Your job is to help everyone focus on those things you can control and, if nothing else, to get through the moment.
Offer to help in any way you can. Fill the freezer, look after children, run errands, house sit or do whatever you can to lighten the patient’s or the caregiver’s load so they can focus on the important things. Encourage the caregivers to look after their own physical and mental health and ensure that they take some time off and away from their loved one, eat, exercise and rest. It is easy to become totally consumed and exhausted in the short term when you need to save your strength for the long haul. Remind your friend that he can’t do it all and that it is important to share the burden. Caring for the caregiver is essential.
Encourage caution in seeking information from the Internet. It is hard to know what information is reliable, what sources to trust and how to evaluate what you do read.
While there are many good, informative sites that can be helpful, and knowledge can alleviate anxiety, there are also many irrelevant personal stories to be found, and one person’s success or failures may have nothing to do with someone else’s. It is best to ask professionals to recommend relevant reading material and reputable websites.
Reframe the situation and be positive.
Hope is essential. No matter how bad things may seem, there are always positives to hold onto, and while we often imagine the worst, our greatest concerns rarely become reality. It is important to focus on the “here and now” and not on the “what if’s.”
Make sure that young children and teenagers get the help they need in discussing their concerns around diagnosis and treatment.
Children often know more than we think they do and are quite sensitive to the mood around the house. It is easy to ignore them as we deal with other seemingly more pressing concerns, but they need attention and TLC. Help keep the lines of communication open while providing as much ageappropriate information as you can.
It seems that it is a rare family that does not have to deal with cancer at some point in their lives. As you deal with both caregiver and loved ones, remember that your presence can be an enormous gift to everyone.
May all your loved ones stay healthy.

Batya Ludman is a licensed clinical psychologist in private practice in Ra’anana. Send correspondence to ludman@netvision.net.il or visit her website at www.drbatyaludman.com.