Cancer nurse, cancer caregiver

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cancernursecancercaregiver_Nanny.jpgBy April Thomas

April began working at MD Anderson as a new graduate nurse in May 2004 in the Department of Thoracic and Cardiovascular Surgery. She remained there for seven years, worked six months in the Post Anesthesia Care Unit and now is in the Gastrointestinal/Colorectal Clinic

Where do I begin? 

I think I will start with here and now, and then work my way backward.

Today is my grandmother, Nanny's, second day in the hospital. She was admitted with pneumonia and chronic obstructive pulmonary disease exacerbation.

This year has been such a roller coaster ride. When she was diagnosed with lung cancer eight months ago, I had no clue what this meant for our little family.

Nanny was too sick for chemo, and because of the size of the cancer and her missing left lower lobe from her previous lung cancer, surgery was not an option. 

Proton therapy was the recommendation and she had 37 treatments. She was treated once per day, five days a week, for seven weeks and two days. 

Nanny battled lung cancer in her left lower lobe 22 years ago and won. She remained cancer free until a new primary cancer decided to take over her right middle and upper lobes.

During the work-up phase, the bronchoscopy (a test to view the airways and diagnose lung disease) was postponed twice. Once for an elevated heart rate, a second time for a severe nose bleed that was seen as a risk for compromising her airway during the procedure. Third time's a charm, right?

The biopsy came back non-small cell lung cancer. She had been admitted to the ER at least six times since her initial diagnosis for varying and unpredictable reasons:

  • heart rate was too high,
  • heart rate was too low (32 beats/minute to be exact),
  • passing out,
  • seizure activity,
  • difficulty breathing,
  • nose bleeds that would not stop,
  • coughing up a cup full of blood, 
  • bleeding in the lung and 
  • pneumonia twice. 
Now I know the true meaning of Murphy's Law: "Anything that can go wrong, will."

What I wasn't prepared for
On top of all of the physical distress that we, as a family, have experienced, there was one other fight we were facing -- the emotional one.

Nanny is a very generous, loving and caring woman. She has always put other people's needs in front of her own. However, when she became ill, I was uncertain that I knew who I was looking at or living with. 

Nanny became demanding, dictatorial and angry. Every time I turned around she was telling me, not asking me, to do something. Go get this, go do that. 

I felt like I was her servant rather than the granddaughter whom she'd raised. I believed I was doing the absolute best that I could do, yet I felt so unappreciated. 

I tried so hard to keep in mind all that she was going through, but there were days that I'd had enough. We have argued, she has yelled at me, I walked out, and she has denied her actions were unreasonable. 

But one thing has remained constant -- knowing that she didn't have anyone else to help her and realizing how much I truly love her. 

Lessons learned

Now, I see things differently. No one could have ever told me how difficult it is to be a caregiver for a patient with cancer.

I never realized how sick they were outside of the hospital. I never understood what the family of a cancer patient goes through until I went through that. 

The experience has taught me so much about this life and has humbled me. I feel that I am a much better nurse now that I can empathize with the patient and my patient's caregivers. 

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