Today at my therapist's, she asked me if I thought my pain issues cause my depression. I don't think so. But we had a discussion on the subject.
I think my emotions have been screwed up since my thyroid cancer diagnosis in 1981. Honestly, don't you think that a cancer diagnosis without any emotional support wouldn't cause depression? It just took a long time for me to realize how screwed up I was. Then at my second cancer diagnosis I decided I needed to be proactive about getting emotional support.
Then my health collapsed and you wonder why I still am depressed. Add some chronic pain into the mix and a bunch of other ailments and you wonder why I am still functioning.
It was nice to have her address it and ask what I thought instead of handing me some 'made up' reason that someone else came up with. I like having an impartial person to discuss my issues with but I think my point of view is important.
Showing posts with label therapist. Show all posts
Showing posts with label therapist. Show all posts
Wednesday, February 22, 2017
Tuesday, August 16, 2016
I Keep Being Asked
My therapist and my meds therapist seem to think I should be getting over my depression. They call it 'post-cancer depression'. I feel some confusion there. Am I supposed to be magically better because I haven't had a cancer recurrence? Seriously. I feel not confusion, but more of a disconnect.
I was first told that I had depression when I first went to a therapist (years) after my first cancer diagnosis. I managed to keep my depression in check after a good deal of therapy and more years of being healthy. Then with my second cancer diagnosis, how funny was it that my depression returned? It didn't help that then my health really tanked.... And my depression hasn't gone away.
Maybe if I was healthy again, my depression wouldn't be as much of a factor in my life. I noticed a few weeks ago when I intentionally spent a day at home by myself that I needed to then spent the next few days out doing something with other people.
Another assumption on the part of my therapists. I guess I now have a project to deal with - training my treatment team. A big part of being a patient is managing your treatment team.
This is the same as an employee needing to manage up - train their manager on what to expect from them as an employee. I learned this lesson early in my career. If you want to grow as an employee you need to make sure your manager understands where you are coming from.
I hope by now you can see where this is going. The same as being a patient. When you see your doctor or a medical professional you need to make sure they understand what is happening in your life. Have you undergone any recent testing, have you had any changes in your recent health, etc. Has your life changed at all? How are they supposed to treat you appropriately if they do not stay up to date with what is going on with you?
So now I need to train my therapists so they can follow what I am doing and understand what is going on in my life. And they can stop their assumptions about my depression.
I was first told that I had depression when I first went to a therapist (years) after my first cancer diagnosis. I managed to keep my depression in check after a good deal of therapy and more years of being healthy. Then with my second cancer diagnosis, how funny was it that my depression returned? It didn't help that then my health really tanked.... And my depression hasn't gone away.
Maybe if I was healthy again, my depression wouldn't be as much of a factor in my life. I noticed a few weeks ago when I intentionally spent a day at home by myself that I needed to then spent the next few days out doing something with other people.
Another assumption on the part of my therapists. I guess I now have a project to deal with - training my treatment team. A big part of being a patient is managing your treatment team.
This is the same as an employee needing to manage up - train their manager on what to expect from them as an employee. I learned this lesson early in my career. If you want to grow as an employee you need to make sure your manager understands where you are coming from.
I hope by now you can see where this is going. The same as being a patient. When you see your doctor or a medical professional you need to make sure they understand what is happening in your life. Have you undergone any recent testing, have you had any changes in your recent health, etc. Has your life changed at all? How are they supposed to treat you appropriately if they do not stay up to date with what is going on with you?
So now I need to train my therapists so they can follow what I am doing and understand what is going on in my life. And they can stop their assumptions about my depression.
Sunday, June 26, 2016
Training the Psychiatrists
I am sure psychiatrists get all sorts of training, but from the patient's point of view, we want them to be trained to understand our problems. My first therapist ever, after a bad boyfriend breakup, was very helpful to me but she hadn't had cancer and didn't get all that part of my emotions. but she was very helpful to me.
After breast cancer, I got a new therapist. She had had breast cancer. She really got that part of me. Then she retired!!!
I tried a new therapist who told me about her ailments more than I told her about my ailments. Then I canned her and found a new one. While she hasn't had cancer, its okay because she understands the rest of me and cancer is not currently my main issue. Actually, I need to rephrase that. Cancer is not my main health issue currently. My main health issue is that my health sucks.
But I digress. This morning I stumbled across an article from The Psychiatric Times explaining breast cancer to psychiatrists. This is a great idea. It discussing its incidence (12% of women world wide).
"To support patients with breast cancer, it is important to understand the trajectory and practical logistics of breast cancer treatment. Psychiatrists should also be aware of possible medication interactions, psychiatric or neurologic adverse effects of treatment, and signs of disease progression—issues that are the focus of this article. "
Um, yes, hello! I have spent a lot of trying to manage medication interactions. Because of all my medications, needing antibiotics gets complicated quickly.
"Adjustment, depressive, and anxiety disorders are the most common forms of neuropsychiatric illness in patients with breast cancer. Risk factors include younger age, receipt of chemotherapy, hormonal disruption (amenorrhea/hot flashes), and marital discord. Symptoms appear to be most prominent at specific points in the course of the illness:
After breast cancer, I got a new therapist. She had had breast cancer. She really got that part of me. Then she retired!!!
I tried a new therapist who told me about her ailments more than I told her about my ailments. Then I canned her and found a new one. While she hasn't had cancer, its okay because she understands the rest of me and cancer is not currently my main issue. Actually, I need to rephrase that. Cancer is not my main health issue currently. My main health issue is that my health sucks.
But I digress. This morning I stumbled across an article from The Psychiatric Times explaining breast cancer to psychiatrists. This is a great idea. It discussing its incidence (12% of women world wide).
"To support patients with breast cancer, it is important to understand the trajectory and practical logistics of breast cancer treatment. Psychiatrists should also be aware of possible medication interactions, psychiatric or neurologic adverse effects of treatment, and signs of disease progression—issues that are the focus of this article. "
Um, yes, hello! I have spent a lot of trying to manage medication interactions. Because of all my medications, needing antibiotics gets complicated quickly.
"Adjustment, depressive, and anxiety disorders are the most common forms of neuropsychiatric illness in patients with breast cancer. Risk factors include younger age, receipt of chemotherapy, hormonal disruption (amenorrhea/hot flashes), and marital discord. Symptoms appear to be most prominent at specific points in the course of the illness:
- At diagnosis
- At completion of active treatment, when patients are confronted with existential angst and fears of recurrence in the setting of less active follow-up with medical providers
- At diagnosis of recurrence or metastasis"
Yoo hoo, that end of active treatment where you oncologist says come back in six months and we all fall apart. That is a key point for cancer patients. I'm not thinking about that last bullet, just shutting it out of my brain.
But I am happy to see this. If a psychiatrist has not had the ailment which is the cause of the anxiety/depression for the patient, they do need additional training so they understand.
Tuesday, August 25, 2015
Back to work....
Today I am back to work after almost three weeks off. I had to dig around to find a pair of pants and haven't yet found my shoes. Summer vacation means shorts, sandals and sneakers, not long pants and work shoes. Our lunches are made (yes I make lunch for both of us every week day) but the nice cat is out so I have to get him back in before leaving. The evil cat is busy plotting our demise....
Yesterday I had a good PT appointment. The therapist thinks that I probably didn't damage any major ligaments and probably only the meniscus, which sometimes does not require surgery. It depends how it heals and how badly it was damaged.
Also my rheumatologist thinks I am doing pretty well - this means no blood work for two whole months and no follow up for three months. Sometimes I have blood work every two weeks and appointments every six weeks so this is much better.
Finally my therapist is an idiot. Okay maybe a little harsh but she doesn't seem to understand my family dynamics so it was a fruitless discussion. She may become my former therapist shortly. After every appointment with her, I wonder why I am still seeing her. But I try to manage the amount of change in my life and next week I see my new PCP for the first time. So the jury is still out but its not looking that good for her. The real decision is do I still need a therapist.
But now to find the cat and my shoes so I can go to work. Maybe they missed me....
Yesterday I had a good PT appointment. The therapist thinks that I probably didn't damage any major ligaments and probably only the meniscus, which sometimes does not require surgery. It depends how it heals and how badly it was damaged.
Also my rheumatologist thinks I am doing pretty well - this means no blood work for two whole months and no follow up for three months. Sometimes I have blood work every two weeks and appointments every six weeks so this is much better.
Finally my therapist is an idiot. Okay maybe a little harsh but she doesn't seem to understand my family dynamics so it was a fruitless discussion. She may become my former therapist shortly. After every appointment with her, I wonder why I am still seeing her. But I try to manage the amount of change in my life and next week I see my new PCP for the first time. So the jury is still out but its not looking that good for her. The real decision is do I still need a therapist.
But now to find the cat and my shoes so I can go to work. Maybe they missed me....
Monday, June 29, 2015
Retraining my doctors
One of the skills I have developed over my years of health ailments is to train my doctors. I can present as a unique patient with my many health issues. I have learned that I need to make sure they are taking all my issues into account without appearing as a paranoid patient. But its all about me when I am paying to see them.
Today I see my second new therapist. My original therapist dared to retire so she recommended a new one for me - who turned out to want to talk about herself more than about me. So I tried a different one and the jury is still out. She keeps suggesting support groups for me. I like the idea of support groups but honestly with my health these days, they can be hard for me to get to. I no longer go to evening events unless obligatory.
I plan on having a discussion with her that she can't just send me to support groups. I want a therapist I can talk to about my health issues and how they can be hard to cope with. I don't want someone to tell me go to a support group to handle your problems. I do not believe there is any support group out there for me because my medical issues are too complex.If she can't be retrained she will be replaced.
Do I use therapy as a crutch? I sometimes debate this with myself. Do I really need therapy? Sometimes I don't. But sometimes I really do. I am dealing with my issues right now that I need to talk about to help me cope. So don't talk to me about a support group, okay?
Today I see my second new therapist. My original therapist dared to retire so she recommended a new one for me - who turned out to want to talk about herself more than about me. So I tried a different one and the jury is still out. She keeps suggesting support groups for me. I like the idea of support groups but honestly with my health these days, they can be hard for me to get to. I no longer go to evening events unless obligatory.
I plan on having a discussion with her that she can't just send me to support groups. I want a therapist I can talk to about my health issues and how they can be hard to cope with. I don't want someone to tell me go to a support group to handle your problems. I do not believe there is any support group out there for me because my medical issues are too complex.If she can't be retrained she will be replaced.
Do I use therapy as a crutch? I sometimes debate this with myself. Do I really need therapy? Sometimes I don't. But sometimes I really do. I am dealing with my issues right now that I need to talk about to help me cope. So don't talk to me about a support group, okay?
Wednesday, June 17, 2015
That cancer part that never goes away
Ask anyone with cancer and they will tell you the cancer part never really ever goes away. You can think, and dream, and ponder, and hope, and do anything you want. You get slashed, burned, and poisoned (surgery, radiation, and chemo) and deal with baldness, nausea, fatigue, weight gain, and more. You get countless scans, blood tests, and millions of doctors.
But it still hangs there in the background to wake you up in the middle of the night with the little 'what ifs'. Those cause the stress that does all sorts of bad things to your body (that might even cause the cancer to come back). And might cause overeating which causes weight gain (which might also cause the cancer to come back.)
You can also go to therapists and support groups and they give you advice on how to deal with your emotions, your feelings, and your fears. They have such great suggestions (my personal favorite is when they told me to avoid fatigue by putting on a terry cloth robe instead of toweling off to save the extra exertion.)
My cynical side often comes out when I am dealing with the cancer things. I am also waiting for that supposed cure that is getting closer and closer every day.
But it still hangs there in the background to wake you up in the middle of the night with the little 'what ifs'. Those cause the stress that does all sorts of bad things to your body (that might even cause the cancer to come back). And might cause overeating which causes weight gain (which might also cause the cancer to come back.)
You can also go to therapists and support groups and they give you advice on how to deal with your emotions, your feelings, and your fears. They have such great suggestions (my personal favorite is when they told me to avoid fatigue by putting on a terry cloth robe instead of toweling off to save the extra exertion.)
My cynical side often comes out when I am dealing with the cancer things. I am also waiting for that supposed cure that is getting closer and closer every day.
Sunday, May 10, 2015
Which support group?
I am a huge fan of support groups. With my first cancer diagnosis (thyroid) in 1981, cancer support groups were for old people, not for college students. (And back then cancer was whispered, not shouted.) With my second cancer diagnosis (breast), I immediately joined a support group (because I was not going to let cancer suck more years of my life). I actually attended two different breast cancer support groups over several years. They were great for me and provided a lot of emotional support group.
I also tried attending a chronic pain support group a few years ago. It was okay, but not very convenient for me and I didn't instantly connect with anyone. It was a big group as well with a range of ailments and ages.
Now I have a new therapist and she suggested I join their new fibromyalgia support group. I am a bit iffy on that. I think my hesitance comes from the fact that my health issues are not as focused on fibromyalgia or any single ailment.
As my blog has changed over recent year, my health has changed as well. I do not have a single focus for my health now. I have multiple ailments with multiple concerns.
I don't only focus on my annual mammogram and follow up with my oncologist any more. I focus on my annual mammogram and follow up with my oncologist and my rheumatologist appointments and my pain management appointments and my endocrinologist appointments and all my related tests and scans.
I need a support group for people with breast and thyroid cancer and fibromylagia and rheumatoid arthritis and bad backs and lymphedema and chronic pain and fatigue. I don't think there are any of those. This is why I have a therapist so I have a personal support group. I think that's the best I can do.
I also tried attending a chronic pain support group a few years ago. It was okay, but not very convenient for me and I didn't instantly connect with anyone. It was a big group as well with a range of ailments and ages.
Now I have a new therapist and she suggested I join their new fibromyalgia support group. I am a bit iffy on that. I think my hesitance comes from the fact that my health issues are not as focused on fibromyalgia or any single ailment.
As my blog has changed over recent year, my health has changed as well. I do not have a single focus for my health now. I have multiple ailments with multiple concerns.
I don't only focus on my annual mammogram and follow up with my oncologist any more. I focus on my annual mammogram and follow up with my oncologist and my rheumatologist appointments and my pain management appointments and my endocrinologist appointments and all my related tests and scans.
I need a support group for people with breast and thyroid cancer and fibromylagia and rheumatoid arthritis and bad backs and lymphedema and chronic pain and fatigue. I don't think there are any of those. This is why I have a therapist so I have a personal support group. I think that's the best I can do.
Tuesday, March 2, 2010
The leg bone is connected to the hip bone
I can't remember the rest of this but you know how it goes the back bone is connected to the hip bone, blah, blah, blah. Last week the lymphedema nurse told me I should consider getting ankle surgery to prevent falling. I started thinking about this. My ankle isn't really getting better. I might wait another month before calling instead of waiting until my appointment in May. No I don't want more surgery but it hurts generally all the time. I just ignore it and go about my life but pain sucks. And is draining. And is stressful.
However, I have to talk to the doctor again. If I have the surgery, I think it was six weeks in a cast and six weeks in a boot. If I am in a cast, I don't know if my back and lymphedema arm can deal with crutches so I need to find out if a walking cast is an option. Gee, that will be fun and be sure to make my back hurt.
In addition, I talked to my back doctor's office yesterday and will have another injection into my right SI joint next week. I was debating this and do think its needed. When I go for a walk, it hurts and generally aches for hours after. Then I get referred pain across my back as a result. But the pain I get now is a lot better than before where it felt like an ice pick in my SI joint when it was acting up.
Otherwise, I hope to get a lymphedema compression sleeve this week. A lovely fashion accessory in medical beige that will coordinate with my wardrobe.
Yesterday I took the cat to the vet and we will get his results today. Either he has this very obscure syndrome or he is a medical mystery. I just wish he wouldn't be such a picky eater and eat the food we give him so he stops losing weight. He lost another 1/2 lb in the past week.
I also got the joy of taking the car to the garage to see if I can get it to pass emissions inspection. Does it count as a 90K maintenance if you do it at 135K? I was thinking about it. According to the dealers records, I hadn't spent anything other than oil changes on the car for the past two years. The year before that I was busy in treatment so I know I didn't do anything to take care of my car either. So this week I get to pay for the equivalent of three years of maintenance in one week. Is this life returning to normal? I hope not.
Today I am going to work, for a walk, and then to my therapist to discuss my stress levels. Maybe I should skip going to her and ask her to read my blog and send me comments? Nah, I need the face to fact interaction.
However, I have to talk to the doctor again. If I have the surgery, I think it was six weeks in a cast and six weeks in a boot. If I am in a cast, I don't know if my back and lymphedema arm can deal with crutches so I need to find out if a walking cast is an option. Gee, that will be fun and be sure to make my back hurt.
In addition, I talked to my back doctor's office yesterday and will have another injection into my right SI joint next week. I was debating this and do think its needed. When I go for a walk, it hurts and generally aches for hours after. Then I get referred pain across my back as a result. But the pain I get now is a lot better than before where it felt like an ice pick in my SI joint when it was acting up.
Otherwise, I hope to get a lymphedema compression sleeve this week. A lovely fashion accessory in medical beige that will coordinate with my wardrobe.
Yesterday I took the cat to the vet and we will get his results today. Either he has this very obscure syndrome or he is a medical mystery. I just wish he wouldn't be such a picky eater and eat the food we give him so he stops losing weight. He lost another 1/2 lb in the past week.
I also got the joy of taking the car to the garage to see if I can get it to pass emissions inspection. Does it count as a 90K maintenance if you do it at 135K? I was thinking about it. According to the dealers records, I hadn't spent anything other than oil changes on the car for the past two years. The year before that I was busy in treatment so I know I didn't do anything to take care of my car either. So this week I get to pay for the equivalent of three years of maintenance in one week. Is this life returning to normal? I hope not.
Today I am going to work, for a walk, and then to my therapist to discuss my stress levels. Maybe I should skip going to her and ask her to read my blog and send me comments? Nah, I need the face to fact interaction.
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