HELPING A PARENT THROUGH CANCER

Helping A Parent Through Cancer

by Elizabeth Pasquale, December 22, 2008 —

As many of you know already, my Mom was diagnosed with cancer just before Thanksgiving. She had a malignant tumor under her right cheek bone, in the sinus, and it was pushing up into her right eye.

Up until now, cancer had been only in my practice. Even when it occurred in my own family, I heard about the surgeries and  treatments usually after they happened. Or an elderly relative would die and I’d hear “cancer”.

But this time it was my Mom and I made the rounds of oncologists.

The first three said that nothing could be done. It was in too difficult a place to remove surgically and so we should go home, call hospice and prepare to die. They each also gave us the name of an oncologist at Beth Israel Hospital, Dr. Mark Urken, and said to see him first. What they said was that he would probably say the same thing, but go see him, because he’s done some of these difficult sinus surgeries.

Dr. Urken told us he could remove the cancer through surgery. He could cut the middle of the mouth, including the palate, the nose and under the eye. If the eye was invaded, which was likely because Mom had begun to have double vision, then he would have to take the eye. He was very sorry about that and said he would do a biopsy during the surgery just to be sure.

Mom said she was afraid to lose half her face. So Dr. Urken told her again exactly what he would do and that Dr. Okay would build her a prosthesis for her mouth and he would rebuild the cheekbone.

Eventually she would get a false eye.

Dr. Okay came in and talked about what he could do and took a mold of her palate.

A nurse, practitioner Jackie Chiang, came in and talked with us and then took me aside to schedule the surgery. We couldn’t have it the following week because that was Thanksgiving. Dec 2 was the day.

Dr Urken told my mom that this was a major surgery. She was strong and had just had a major surgery, a shoulder replacement in June, and had come through great. This surgery was major and would be tough. But there was no effective alternative. Radiation would not work on this type of aggressive tumor.

My purpose in writing this is because of what I learned about traumatic stress, aka post traumatic stress disorder, which we hear so much about when it comes to our war veterans.

We don’t hear about it much when it comes to surgery. My mom had a 6 hour procedure in which her face was cut into, her cheek bone, upper palate and right teeth and eye removed, her scalp cut to get replacement tissue, a piece of titanium inserted for a new eye socket, the right side of her neck cut to take lymph nodes and a square of tissue taken from her thigh leaving a big red bruise.

Having met Dr. Mark Urken and his surgical partner of 20 plus years, Dr. Buckbinder, I know it was done with the utmost care and loving compassion.

Unfortunately for mom’s unconscious body, her cells felt that they were being attacked while she slept. Her body felt as if someone was trying to kill her.

I took the night shift and by that I mean I spent the nights at the hospital with mom. My dad and siblings would come and sit with her all day. (We are lucky to be a big family.) I would come at 7 or 8 PM and stay until 7 AM and sometimes until Dad arrived at 10 or 11 AM. Mom was 8 days in the hospital after the surgery. I could go home by day and see a client or 2 and catch up on paper work and phone calls.

I didn’t know I would be so happy to have my USANA business. USANA is a company that markets top quality nutritional products.  As soon as Mom came out of intensive care (she was there 3 days), they said she could eat only shakes, soups, and puddings. I immediately began an aggressive nutritional supplementation program. I made her USANA shakes twice daily with USANA’s very potent vitamin supplements pulverized and added to the shakes.

I am certain that is why she regained health so quickly with no complications of infection. She got pneumonia right after surgery in the ICU, but it went away very quickly, in less than 2 weeks, when it can be a serious complication for elderly patients.

Here’s what I found out about trauma and surgical recovery:

My mom had a really hard time sleeping after the surgery. At first it was nightmares that woke her up after a few minutes of falling into deep sleep.

My practice of CranioSacral Therapy (CST) has taught me to communicate nonverbally on the cellular level, the unconscious level, with my clients. So I began to ask mom’s cells what they were feeling. They “told” me that they were afraid to let mom go to sleep because the “attack” came while she was asleep. So they created nightmares that would be sure to wake her, thereby “protecting” her from another attack which might come during sleep.

I used CST to talk with the cells. I explained to them why the surgery was not an attack, but a life saving method. It was a tough sell.

I explained that she needed sleep to heal. I then used the Emotional Freedom Technique (EFT) from Gary Craig (emofree.com) to release energetic blockages caused by the trauma to get the cells to give up their fear, relax, and let her sleep.

I went through the EFT treatment, which consisted of tapping places on Mom’s body, meridian points, the same ones used in acupuncture. I did the EFT treatment numerous times over my 8 day stay, and when I did, I could always feel Mom’s breathing change and she would fall into a deep sleep. After 2 or 3 days, the nightmares ceased almost completely.

Because of the significance of the surgery, the added fears in the recovery intensive care unit, and minor panics and assaults that come from being in a hospital, no matter how ideal the situation is, one session was not going to be enough.

The CST and EFT had to be repeated daily to address changing concerns and new ones. Mom healed rapidly and well.

Another difficulty was the swelling. Mom put on about 15 pounds of fluid. Her face was initially swollen almost beyond recognition and her body as well. It was hard for her to move or coordinate her fingers or toes. Of course, she couldn’t swallow at first and it was days before the trach was removed from her throat.

All this was very scary. I used Lymph Drainage Therapy (LDT) daily to release the swelling, especially around the face. The day after surgery, I worked manually with a light touch, keeping a distance from the fresh incision sites and I worked energetically, on the incision sites, at a distance from them. I was soon able to work very lightly directly on the incisions and on the rebuilt cheek.

With LDT, the way I learned it from Dr. Bruno Chikly, I can feel the flow of lymph under my fingers. When I first felt Mom’s, it was totally shocked and stagnant. In the area on the right neck where they had removed the nodes, the direction of flow after a day or so was detoured around that area, crossing behind the cervical vertebrae to the other side and down the left.

A few days later, the lymph was able to go down the right in a fairly normal fashion, sans nodes. What an amazing recovery system the body has! So ingenuous!

I felt the lymph of the check, hard like plastic at first and days later moving and become more flesh like. The lymph around each of the sutures took only days to figure out detours around the stitched areas. In less than 2 weeks the facial scars along the nose completely disappeared.

We were warned to watch for infection, redness around the sutures. I never even saw a hint of pinkness or felt any warmth at all.

I often work on people months or even years after surgeries. I feel the lymph is still congested around those areas even years later. Through LDT, I help the lymph return to either a normal or alternative pathway, allowing the person to feel a comfort not felt since the surgery. I wonder how much longer it would have taken Mom to heal if I didn’t have these skills.

Another thing to mention: when I say I did CST & EFT repeatedly during Mom’s stay at the hospital and later at home, I didn’t do it in my traditional way as I would in my clinic. Because Mom was often not very accessible in the hospital bed, I was forced to work energetically and mind-to-mind, with much less hands-on than I normally do in my clinic. Instead of putting my hands on my Mom to address an area, and tapping on a meridian with my fingers in EFT or manipulating a bone in CST, I would merely imagine it instead. I found years before in my practice that vividly imagining it and doing it produce the same result. Also, because I was often half-asleep when I worked on her (which is in no way a deterrent, but an advantage), I was able to do things my conscious mind would have interfered with had it been awake.

Eight days after surgery, we came home. Mom would sleep upright on the sofa, her legs up on a hassock. She came home with pneumonia and had a deep hacking cough, so it made sense for her to sleep sitting up.

Almost every morning at 4 AM, Mom would wake up and we would discuss her decision to live. She wondered if it was the right choice. Her quality of life would be diminished. She wouldn’t be able to eat, drink or look normal. I would explain both to her conscious and unconscious, which at 4 AM is very accessible, that she was already eating soup, shakes, and taking tea. She would soon be able to eat and her swelling went down daily by 2 or 3 pounds of fluid.

I told her if she decided to die, I would honor her decision. But she must not think that it would be easy to die. Dying would also be very hard work. Either way, living or dying, both would be the biggest challenges of her life.

Every night we wrestled with the fear of going to sleep. There were no more nightmares, but still Mom was afraid to sleep. With the EFT, CST & LDT, after a few days at home she was awake all day, on the computer, participating in life and that night, she slept 11 hours. I felt success. We had turned the corner. Soon she would be back up in her bed and I could live in my own home again.

We had a great visit with Dr. Urken, Dr. Okay and the whole team the next day in NYC. We came home optimistic and upbeat. That night, around midnight, I suggested Mom go to bed. She said, “No, I’ll watch TV first.” I felt my heart sink as she sat in front of the TV with Dad, watching a murder movie.

To the rest of the family, it looked comforting to see them in their old habits. I was unsure. When Mom went to “bed” in the chair, she was visibly upset.

I went to sleep in my post on the couch an arms-reach away.She awoke repeatedly, every hour or so, saying she couldn’t sleep. I was more in sleep mode than therapy mode, so I watched and didn’t jump in, wondering what had happened to set us back.

At four AM we talked. I was thinking, “What was different tonight from last night when she slept so well?” She said, “I’m afraid of going to sleep.”

I realized the doctor visit had stirred fears up again. I had seen her very nervous when we were there and had done LDT on her as we waited for the doctors to arrive to talk with us. But the visit was enough to set off unconscious and conscious alarms.

Also, I told her, she had watched TV, a murder movie, just before bed and that had set off alarms as well. She said she was afraid of dying in her sleep. I did EFT on the fear of dying in her sleep.

She was telling herself over and over, “I can’t sleep, I can’t sleep.” I pointed out that her body was obliging her and waking her up as she was requesting.

I told her to tell her body instead, “I could sleep much better. I love a good nights sleep. I want to awake alive, alert, joyous and enthusiastic about this new day.”

I hardly finished my sentence when she fell into a deep sleep and slept soundly from then to 9 AM.

So I can see there is more work to do. Tonight I will have to go over this with her. I’ll tell her she has choices here. To have a good nights sleep, she can

1. Go to bed early, by 10 or 11.

2. Don’t watch TV before bed. Instead, read something funny or light hearted or inspirational. Or watch a funny movie.

3. Tell your body that you love to sleep, enjoy a good nights sleep, feel safe and happy.

4. Tell your body you want to awake alive, alert, joyous and enthusiastic about this new day!

5. As soon as you awake say, “I am alive, alert, joyous and enthusiastic about this new day. I fairly sizzle with joy and enthusiasm. Always in the right place at the right time, I admire the way the Universe conspires on my behalf with synchronistic magical opportunities that I act on now!”

Step out of bed and as one foot hits the floor, say “Thank.” As the other foot hits, say “you.” Trot to the bathroom saying “thank you, thank you, thank you…”

It’s now a week later. After a good EFT session, Mom began sleeping in her bed and hasn’t had any trouble sleeping for a few nights now.

The prosthesis in her mouth is the challenge now. She wants to learn how to do it herself so she can be independent, yet she is unsure of her ability to do this and panics. We’ve been doing the EFT on this fear so I’ll let you know how it goes.

The other day, she vented her anger, fear, and frustration. She said, “They shouldn’t be allowed to do this to people! I am a cripple! They made it out to be so easy! They said I would have a glass eye! Where is my eye? When will I get it?”

Then after we did EFT, she was calmer and said, “I shouldn’t complain. I know I will get through this. I can do it. I don’t have any pain. I’m getting better every day. It’s just hard right now.”

Reverse the Irreversable? Anti-aging? You must be dreaming!

Some time ago a 14 year old girl came into my therapy office, brought in by her family which included Mom and sisters.  Let’s call the girl Sarah.

Sarah could barely make it up my 3 flights of stairs.  She walked with difficulty with a cane.  Sarah had had leukemia, which was in remission.  But cancer treatments which had saved her life had also disabled her.  

According to her doctors, she had the bone density of a 90 year old–severe osteoporosis.  On good days she could walk with a cane.  Bad days meant a wheelchair.  The doctors told her that her condition was irreversible and that it would only get worse with time.
(more…)

Behind The Curtain: Helping a Parent Though Cancer Part 16

Pasquale family at the dedication of the echolab at Christiana Hospital.  I’m at the bottom right and Mom is over my right shoulder.  Dad is standing behind Eileen’s mom to my left.

It’s holiday time and many of us are thinking about the ones who are not here to share it with us.  As I was washing the dishes this morning, I was crying at the loss of my brother, Mike, who died in September, not of the cancer he had, but of the opportunistic infections he couldn’t beat.

At the same time that I was crying, I was marveling how my body could automatically be washing the dishes.

Then I thought, didn’t I dream of Mike last night? Yes I did.  In the dream, I asked him, “Why did you leave us?” I couldn’t remember the answer. so  asked out loud, “What was your answer, in my dream?  What was it you said, Mike?  Why did you leave us?”

All I could remember was that the dream was comforting and I intended  to tell my sister-in-law, Mike’s wife, Eileen about it.   In the wee hours of the night, it seemed like a revelation.  Now I couldn’t remember.

At the sink, as I washed the dishes, I saw Mike clearly, laughing.  He said, “I told you that I haven’t left you.  I’m with you.  Just think of me as behind a curtain.” He had that bemused look on his face, smiling, as he so often did.

Behind a curtain.  Like the wizard of OZ?  In the light of day, with water splashing in the sink, it wasn’t nearly as satisfying an answer as it had been earlier.

The Center for Heart & Vascular Health at Christiana Hospital in Wilmington, Delaware dedicated its echocardiography laboratory to my brother on Monday, December 7, 2009 calling it the Michael J. Pasquale, M.D. Echocardiography Laboratory.

The dedication was to be at 3 PM, so at 10 AM, I picked up my parents in New Jersey and we met up with the family at Eileen and Mike’s  house outside of Wilmington.  My brother, John, had come with his wife, Patty, and their 2 boys, Sean and Andrew, twins about 12 years old, and their oldest daughter, Amanda, 25.

My brother, Mike’s, children were all there–Chris, 27, Kimberly, 25, and Nicole, 22.  Carolann, 25, my sister, Ann’s daughter, and her boyfriend, Kyle, were there, too.  Eileen’s 92 year old mother completed the group.

It’s hard to describe the feeling’s in Eileen’s kitchen that morning.  We were cheerful.  The underlying strain of grief was also present.

We were met at the hospital by an auditorium full of Mike’s colleagues, hospital administrators, cardiology fellows, nurses, friends and patients.  Dr. Timothy Gardner, the medical director, spoke first. Then Dr. William Weintraub, the cardiology chair and my brother’s partner.

My brother had been a cardiologist, hired 20 years earlier, and these 2 men spoke about how Mike had left his mark at Christiana Hospital.  Besides being an excellent doctor that was the “go to” guy in the department, he was adamant about introducing the new technologies of cardiac care into Christiana.  But where he really shown, was teaching the new cardiology fellows.

My family sat in the reserved first row of seats, filling both sides of the aisles.  We listened as each speaker spoke with enthusiasm about Mike’s contribution to the hospital.  Of course, we were grateful and happy.  At the same time, the tears were streaming down my cheeks and when I turned to look at my brother, John, beside me, his eyes were drowning , too.  My parents and Eileen and the kids were on the other side of the aisle.  I could only imagine the tug of war going on in their hearts.

The speech that moved me most was the one from my nephew, Chris.  I was so grateful for his words, his acceptance of this honor on the part of my family.  He said

“I’d like to start by thanking Dr. Gardner, Dr. Weintraub, and everyone else who helped to make today happen on behalf of my family. It means so much to us to have my dad honored in this way.

You all knew my father as a colleague and it’s that professional aspect of his life that we’re here today to celebrate. Many of you also knew him as a friend. My relationship with him was obviously from a different perspective.

However, if there is one thing I’ve come to realize about my dad over the past few months, it’s that he approached every aspect of his life in a similar way. And so I think that there is likely some common ground in what we each took from the relationship.

Many of my memories of my father growing up were also from working with him. Although, for me, it was working in the garden or around the house on Saturday mornings.

My dad was a do-it yourself kind of guy. No task was too daunting and I think he made my mom nervous on more than one occasion with the projects we attempted.

He was also a do-it the right way kind of guy. “Good enough” never was. And although I didn’t always share his zeal for perfection at the time, especially as Saturday morning turned into Saturday afternoon, he taught me what it meant to take pride in your work, to strive for excellence, and to make going above and beyond normal operating procedure.

He applied this philosophy to everything he did, whether it was running guys half his age ragged on the tennis court, growing baseball bat sized zucchinis in his vegetable garden, or even something as simple as putting up the Christmas lights, which always had to go in the back yard as well as the front even if only our neighbors would see them.

As we’ve heard today, he brought this drive to his profession as well. He was passionate about helping patients, passionate about honing the skills of his craft, and passionate about passing on his knowledge to others.

And although he didn’t talk much about his work when he came home, the outpouring of sympathy and respect from his colleagues, fellows, and patients over the past few months has been truly humbling and a testament to how successfully he achieved these objectives.

I can think of no better way to commemorate my father’s life than to continue to pursue these ideals. Having met many of you here at Christiana and the Echo Lab in particular, I’m confident that you share his passion and I couldn’t be more proud to have his name associated with the outstanding work you do here.

Thank you again.”

There was a beautiful luncheon served and we as a family were taken right away on a tour of the echocardiology lab.  As we walked down the hall, Dr. Gardner told me that after Mike died, there had been a ground swell of support to name the new lab after Mike.  It came on behalf of Mike’s colleagues who worked there.  He had left his hand in it so prominently, his striving for excellence for everyone who worked there, his insistence on the latest technology and finest care for the patients.

Michelle Marstom, RDCS, Supervisor of Echocardiography Lab, in the break room. Notice Mike’s picture top left above the family photos.

When we toured the lab, I poked my head around the corner where the nurses were hiding in the break room.  On the back of the door were pictures of their kids, and at the top was a picture of Mike, whom they called “Dr. P”.  Michelle Marston, RDCS, the supervisor of the lab, said they keep his picture there to remind them of his presence in the lab.

Below his smiling face in script it said, “Quality is job one!”  Michelle said each week they change the picture and put it up with a  different “Dr. P’ism”.

“He always used to say these things and he was always right,”  Michelle said.

I was touched to see 3 months after his death, they had incorporated a ritual to remember him.

Dr. Vinay Hosmane was one the first graduating cardiology fellows trained by Mike.  He told me the following “Dr. P’ism”.

Dr. Hosmane said when they were learning to read the echocardiograms, in the beginning, the echos all looked like indecipherable clouds of black and gray.  Mike would say to them, “Be a man. Take a stand.  Make a call.”

It seems many cardiologists will hem and haw.  Mike demanded those under his tutelage, as well as colleagues, call the echo, normal or abnormal, without beating around the bush to protect themselves for fear of being wrong.

I thought how profound this was for life outside cardiology.

Another fellow said on his first days as Mike’s student, he was given what seemed to him a huge amount of work to do for day one, Monday.  There were these plastic partitions dividing the office where they met.  The fellow was frantically checking the books, reading, and making last minute changes.

He heard Mike calling his name, his voice booming, “Reading is on your own time!”  Even though Mike couldn’t see what he was doing, he knew, and he was calling him on it.  He was a tough taskmaster and they appreciated it and it made them chuckle.  They all remarked how Mike did it with a big heart and was always fair.

Through all this, I have come to know that there were so many things I didn’t know about my brother.  I look at the others in my family and I think, “What don’t I know about each one of them?  How do I find out, while they are still alive, and I can tell them how much I appreciate them?”

Do you want to know something really odd?  After we had returned to Mike and Eileen’s house, I was sitting with her mom.  And she told me about how her husband had died at age 54 of cancer, the same age as Mike.  She said that he began to go to the doctor for treatments in the spring of that year.  He never told her what the treatments were for.  Then she took him to the doctor after Thanksgiving because he was having trouble walking.  The doctor told her he was being admitted to the hospital and would be dead in a couple of weeks.

That was the first she heard about cancer.  Her husband was dead before Christmas.

“So,” she said, “I know how hard it is to have this happen.  I know how hard the holidays are.”

I don’t believe in coincidence.  I believe in synchronicity.  I can explain it as energy patterns that spin around us, directing us to certain people, we become actors in this play of life, as hokey as it sounds.  At the end of it all, we get to read the entire script as well as our part in it, and it will make sense.

Enjoying Mom! Helping a Parent Through Cancer Part 15

Mom and I September 08

Its Thanksgiving time again and it’s a little over a year since Mom got her diagnosis.  She’s went through cancer treatment and now recovery and the whole family has gone with her on this wild ride.

Her birthday is November 11 and last November 11 we had just gotten her diagnosis, aggressive melanoma tumor located in her right nasal sinus.  That meant a nasty tumor under her eye which had already invaded the eye.  We talked with 4 doctors and the last one, Dr. Urken of Beth Israel Hospital, said he could operate and remove the tumor.  We were waiting to hear when the surgery would be.

(more…)

Well On The Way
The Natural Way To Well Being
191 Main St., 2nd Floor, Ossining, New York 10562
(914) 762-4693