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(June 2007)

Facing the diagnosis.

I have discovered that most serious, chronic, or even life-threatening illnesses are rarely anticipated even when there is a family history that may indicate a genetic predisposition for that illness. 

Women who are overly attentive to their bodies and visit their doctors too often (i.e., suffer from hypochondriasis) are as equally shocked when a serious illness is diagnosed as those who considered themselves very healthy and visit the doctor rarely. 

The symptoms of minor illness such as colds, flu, allergies, bladder and vaginal infections are easily identified, widely known, and lead some women to the doctor, others to their neighborhood drugstore for over the counter remedies, and yet others to a steam kettle and chicken soup.  With those illnesses, we give ourselves a week or so to recover or a few weeks if it’s a stubborn infection.  We willingly take antibiotics and temporary regimes to ease pain and discomfort.  Within days or sometimes weeks our lives are back to normal.

Serious, chronic illnesses are very often discovered, not through the appearance of symptoms, but through routine blood tests, Pap smears, mammograms, or sigmoidoscopies.  After receiving dozens of negatives over the years, we are stunned when a positive result comes back.  Even when there are serious symptoms such as persistent pain, bleeding, blinding headaches, our capacity for denial is remarkable as we explain away the symptoms over long periods of time.  I have witnessed this in several instances of colon cancer.  Some life-threatening illness such as certain types of cancer come on so suddenly and with such ferocity that there is no time to deny or accept the diagnosis and treatment options are minimal.

Looking at all of the above, it is easy to see why the first reaction to the diagnosis of serious chronic or life-threatening illness is psychological shock.  Unfortunately, when we are in shock, we are either frozen mentally and physically or we are flooded with adrenalin.  Either state, paralysis or agitation and fear, makes decision-making, action steps, and emotional adaptation very difficult. 

This is a time to seek the support of family and friends, even though it is hard to share the news.  A family member or friend may be better able to ask the appropriate questions, hear the recommendations, and help us overcome avoidance and denial in taking next steps.  

The search for treatment options:

 Initially, most women simple comply with whatever treatment options or extended diagnostic work is recommended by their doctor.

When it is a serious, chronic condition such as Type II diabetes, hypertension, MS, or fibromyalgia, women are usually willing to start medications or other therapies and often find support groups or educational classes that are helpful.  But the adjustments that must be made in lifestyle, body image, and activity level are very difficult.  We are used to dealing with an illness that has an end to it.  The transition from dealing with an acute illness to a chronic illness, one that runs its course regardless of treatment compliance, is a difficult one.  I find that it takes a year or even many years to make a successful adjustment.  Supportive counseling and support groups, in particular, can aid the process of adjustment.

When it is a life-threatening diagnosis, the first response is get it treated NOW.  The frustration of waiting for tests to be run, results to be returned, treatment options to be chosen, then started, quickly turns anxiety to panic and even anger.  We want IT out…and out now!  Again, having advocates and general support is essential.  The problem is that this type of advocacy and care is a female forte.   When the husband steps in, especially if the doctor is male, it can feel like the members of the old boys club aren’t taking things seriously enough.  Women have a hard time asking for the level of assistance that they need and make the mistake, sometimes, of going to the dry well.

Endless doctor shopping to find the answer we want to hear can also be very disruptive when taken past the second or third opinion.  It slows down the acceptance process and may even interfere with proceeding with treatment of any kind.   

Why acceptance is so difficult. 

With serious, chronic illness that same reluctance that keeps us from altering our food plans on a lifetime basis makes us reluctant to take medications or change our lifestyle.  Women who multi-tasked, were very active, and did things on the spur of the moment, hate pacing themselves, resting, doing only one thing a day, and being more sedentary.  In addition, activity level, in and of itself, is a great psychological defense mechanism.  We don’t have time to think about our problems.  When activity is greatly attenuated, old emotional wounds, unresolved relationship problems, and odd bits and pieces of low self-esteem, rise to the surface and threaten to undo us.

With life-threatening illness, acceptance can be inappropriately equated with giving up.  Many a client has talked with me about their dying process, their wishes for their services, their thoughts on the life hereafter, because family members will not allow them to speak such words in the belief that it means they are giving up the fight for life.  That ability to explore the spiritual side of our final transition AND fight for life at the same time is possible.  A pastoral or psychological counselor can be of great help. 

Is there a right way to deal with serious or life-threatening illness? 

There is no right or wrong way.  Our emotions run the gamut from shock and denial, to depression, to anger, to bargaining, and finally to acceptance.  If that sounds familiar, it is.  It describes the stages of grief.  When we acquire a chronic or life-threatening illness, we are grieving the loss of life as it has been, of our health.  The entire aging process collapses in upon us.  Plans for the future are changed or abandoned.  Relationships are altered when we find some loved ones cannot weather the oncoming storm. 

On the positive side, there can be growth.  We can rediscover ourselves as human beings not human doings, old friendships are strengthened, new friends enter our lives, our spiritual side is deepened or discovered, and the important things in life are beheld with a new clarity.