Zipping Along

My wonderful hubby loves setting goals.  He knows what he wants to do in the next five, ten, even twenty years.  I admire him greatly for this ability to look ahead and plan for the future - he takes wonderful care of us both in the present and the future.  One thing that concerns me a bit, though, is how quickly things move along lately - and how close those five year goals are to being a reality.

I blinked and a decade of marriage came and went, not to mention an elementary school-age child who is quickly gaining on my height and baby who is quickly mastering milestones.  One of my students this past semester innocently asked how long I had been a nurse and I almost gasped when I calculated the years and realized I was no longer a novice nurse admitting to her patients a relative lack of experience.  My home hospital unit is moving locations, affording the opportunity to journey back through highs and lows of several years of memories from full time swing shifts, trying to lift patients around a pregnant belly, a parade of faces and circumstances both happy and sad, mistakes and successes, scores of students, the wonderful view from the top of the hospital over a multitude of changing seasons and winter and summer storms, and the trip to a manager's office to request a last-minute adoptive maternity leave.  It all went by awfully fast.

The benefit to starting out doing things (relatively) young is that one can not be too aged and still have a decade or two experience doing something.  Living in one's head all the time makes one an old soul, anyway.   I'm excited for all the things coming up, but have a much harder time than my spouse envisioning and planning the future.  I love being a nurse, mom, educator of wannabe nurses and my own children.  But how does it all fit together and how do I want to plan out the things I love?  That is less clear.  It is more difficult to fit together the pieces given a finite amount of time and energy, much less trying to stay on top of the goals for the day or week ahead (plan meals, scrub kitchen, get groceries, weed garden, reply to e-mails...).  Is it a personal deficit to not have a bucket list, or a ten-year plan?

It's easier to think about the far-away future - when I'm 55 or 60 I can think of a few things I would like to have under my belt.  Be pampering grandchildren.  Finally knit those "advanced" pattern with cabling, lace, shaping, and the whole works.  Be able to cook up one mean meal with everything done all at the same time.  Nourish a beautiful and unique flower bed without a single weed to be found.  But where will we live, how will I be employed (or will I?), will my kids have graduated from my school or someone else's?  Time and the Lord will tell, and, it won't be long.

Amen, Sister.

It's October.  Pink bags of dog food.  Pink flags from football refs.  Must say the words "breast cancer" and "mammogram" on the news Every. Single. Night.

This is what I was going to post, but it was already written by someone else, so thank you, Simcha.

Want to actually help someone with cancer?  Bring them a meal.  Shovel their walk.  Sit and talk for a couple minutes.  Fill their tank with gas, especially if they are driving 150 miles for treatments.  That's the thing about helping - it actually means helping, not just licking the yogurt off the pink lid you were going to throw away but had to walk two extra steps to the collection jar instead of the garbage.

I'm probably being way too critical.  But being a cancer nurse, I'm always amazed at the number of people who sit in their beds alone, who don't have a ride to get to chemo, who are just downright scared.  Or their caregivers who haven't had a break to take a shower for four days.  It doesn't matter that the volunteer who shows up is wearing a pink shirt - it matters that they are there.  I so totally agree we need more and better research to find better treatments and to continue to revolutionize diagnosis, treatment, and survivorship care.  If that's the case, then let's find meaningful, effective ways to fund the research beyond yogurt lids and puppy chow.

By the way, I'm hoping to start a trend - think it will catch on?  Wear a poo-brown shirt every day for colon cancer awareness month and be sure to buy the bottles of laxatives with 10 cents toward the "Save the Guts" foundation.  I think it will be a wild hit.

Komen - Now you Know

The Susan G. Komen Foundation briefly interrupted funding for grants to Planned Parenthood this week due to their policy of not funding organizations which are under investigation. During the three day period, several individuals and organizations gave PP 3 million dollars. Then Komen revised their policies to state they may not fund organizations which have been actually found to have committed serious wrongs, and they have resumed funding to PP. According to the AP news story in our paper, several branches of Komen were flat-out refusing to abide by the policy and continued funding during the three day period.

I am quite disgusted by Komen's reversal of their decision (although it didn't seem to be a decision they really wanted to make in the first place), but it is nice to actually have this information out in the open. Komen supplies hundreds of thousands of dollars to PP for "preventive services" - i.e. mammograms. The AP news story went on to say that PP did - get this - 6500 mammograms last year. Sound like a lot? Consider that PP is a nationwide provider. There are over 300 million residents in the US, about half are women, and of course not all of them are of breast health age, but a significant proportion are. So out of the, say, 75 million women who may need an annual mammogram, PP provided mammograms for 6500 of them. And I doubt it costs hundreds of thousands of dollars to do 6500 mammograms. Where do you think the extra money might go? To put it in additional perspective, I would imagine our area hospital provides about the same number of mammograms to residents in our rather small geographic area.

Bottom line - Komen has made it very clear what their underlying agenda is and we should avoid them and all their campaigns like the plague. If you really want to help someone with cancer, give them a call and offer to come help clean house, cook a meal, or drive them to their next appointment.

Anti-Pink Rant, continued

Earlier I posted about the public frenzy of breast cancer awareness and pink saturation in Octobers. This is a follow-up to that conversation. The Oncology Nursing Forum is a peer-reviewed journal I receive through my membership in ONS. The articles are excellent, and here is the evidence:

"Several women stated in a rather frustrated tone a need to be viewed by providers as a whole person and not in a reductionist way limited by the disease of breast cancer. Women overwhelmingly described not identifying with common breast cancer symbols. Several stated 'I do not even like pink' or 'I am sick of the whole pink campaign'. Others noted, 'It feels like we are being marketed.' One participant captured that sentiment.
'I do not see myself as a breast cancer victim and I really hate... the pink ribbons, the bracelets, the walks, the fund-raisers. I want to scream when people who are really only trying to be nice give me pink things. I'm so much more than that. I do not identify with breast cancer and this "I'm a survivor" thing.' " (pg. 73) ....

"Both the focus group leader and observed noted that none of the participants who came to the focus groups worse any pink items, breast cancer bracelets, or any other symbols associated with breast cancer. As a result, the authors asked the women who participated by phone whether they wore such items and the response was a loud, collective 'No.' " (pg. 73)

"Lastly, the participants in these focus groups did not identify with breast cancer as a disease and found the need to do so limiting. They wanted to be known by more than 'pink ribbons' and 'breast cancer pins, walks, and yogurt.' That suggest congruency existed with the theoretical assumptions of Rogers (1992), who stated that human beings cannot be reduced to a disease entity." (pg. 76)

Flanagan, J., Winters, L.N., Habin, K., & Cashavelly, B. (2011). Women's experiences with antiestrogen therapy to treat breast cancer. Oncology Nursing Forum, 39(1), 70-77.

My personal opinion is that the pink campaigns exist as some sort of a public coping mechanism. We are all terrified of cancer and saving pink yogurt lids gives us some sort of sense that we are doing something about it. The pink campaigns do not exist for the cancer sufferers and survivors, as we like to think they do, but as a way of expressing our personal discomfort with our own mortality. Research also indicates that most people have unrealistic views and attitudes towards cancer ("a death sentence", "never curable", etc.), so if we can pour money into research, perhaps we will never have to face these demons. I may be reaching, but I think there might be something to this.

Awareness - of what???

I've tagged this with the grad school tag, but it really just falls under the STUPID THINGS category.

I've begun to dread October because of the pink saturation and demonstrations of public idiocy. Before anyone jumps up swinging, let me remind you I do care for cancer patients for a living and yes, I know 1 in 9 US women will develop breast cancer at some point in her life. This is a big deal for a multitude of reasons. I don't argue that on any level.

BUT - what awareness is raised by putting pink ribbons on dog food, yogurt, shopping bags, razors, and everything else we buy? I go out of my way to avoid buying all those pink ribboned products, mostly because anything with a pink ribbon means you are giving money to Susan G Komen and similar organizations who support breast cancer research using embryonic stem cells. (Yes, it's true.)

And even worse, what awareness is raised by these bra-themed events? Like draping strings of bras off buildings or across streets? I could be wrong, but I don't think women are driving along thinking, "Look at those bras. I really should do a breast self-exam every month." And I'm 99% positive the men are definitely not thinking along those lines. Never mind that breast self-exams, while useful for early detection, actually haven't been proven to improve overall incidence and survival rates. Not that people shouldn't do these, but in terms of overall cost benefit (if you're thinking big picture) cancer screenings tend to be less useful than we would hope.

As a whole, the obsession with preserving anatomy as evidenced by many of these "awareness" campaigns smacks of misguided and obsessive sexuality. What about preserving physical wholeness since our bodies are a temple of the Holy Spirit? If we are so worried about our bodies, why do we insist on continuing behaviors that harm us in so many other ways? I know I'm preaching to the choir, but there is a demonstrated link between use of oral contraceptives and abortion with development of breast cancer, usually at earlier ages. And that's something you won't seen broadcast on your nightly news, nor will you be encouraged to have children and breastfeed them (things that have been proven to reduce one's risk).

Oh, and let's raise awareness about ALL the other kinds of cancer that people are living with every single day. But I doubt you will see colonoscopes hanging off the area hotels any time soon.

Why I Do What I Do...

I left the hospital last night feeling I had been trying to fill up a bathtub with an eye-dropper. The start of clinicals each semester is daunting - take 8 students who don't have a lot of knowledge yet and throw them in with complex, ill, hurting patients. They are just starting to discover what nursing REALLY IS (a verbatim comment: "Wow, being a nurse is really hard work."). How on earth do I teach them how to do symptom management, communicate sensitively and empathetically, truly understand what cancer is, how we treat it, how to prevent and/or treat all the side effects of nasty treatment, and help patients and their families through this fight-of-a-lifetime?

I'm hoping to do my independent project for my master's on students in the oncology setting. How do we successfully prepare nurses to care for people with cancer in a variety of settings - not only hospital, but in the community and those who are now survivors or facing the end of life? That's an extremely broad question, and I'll be narrowing it down much further, though a daunting process as well (1st part due next Friday!). So I've been mulling over these things, and came across the obituary of a young girl in our community who passed away from cancer this week. She wrote her own obit, and at the end she thanked her doctors and nurses for helping her. But she asked that we continue to find a way so that no child have to die of cancer as she did. Even though I don't know how to stop cancer in its tracks, I do know how to be present, how to care, how to perform the necessary skills as we gain new tools. And if I can pass on this knowledge to our future nurses, maybe they eventually will be the ones who will find the treatments so no more children, friends, parents, siblings, die of cancer. So I will take my eye-dropper along next week and fill up that bathtub one drop at a time.

What Cancer Cannot Do

It cannot cripple Love

It cannot shatter Hope

It cannot corrode Faith

It cannot destroy Peace

It cannot kill Friendship

It cannot suppress Memories

It cannot silence Courage

It cannot invade the Soul

It cannot steal Eternal Life

It cannot conquer the Spirit.

-Author Unknown