In the Beginning
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By Hester Hill Schnipper

In the Beginning

Find help managing the first days and weeks after diagnosis

By Hester Hill Schnipper


Emotional roller coaster

This is as bad as it gets. There are few promises associated with cancer treatment, but this is one: The first days and weeks after hearing a cancer diagnosis are always an emotional catastrophe. You can think of little else but cancer. Probably, you are not sleeping well, and eating either not enough or way too much. You are in the front car of the infamous emotional roller coaster, holding on tightly, and at the mercy of intense feelings and too many medical appointments.

It will get better. Once you have completed any staging tests, finished needed surgeries, seen your final pathology reports, consulted with your doctors and developed a treatment plan, life will begin to settle down. Although no one is happy about beginning chemotherapy or radiation therapy or learning that additional surgery will be required, there is a growing sense of control after you know the facts. A routine will develop, you will adapt to whatever is necessary, and any treatments will likely not be as bad as you imagine.

What can you do in the meantime? It helps to break down time. Concentrate on getting through half a day—or even half an hour—at a time. Don’t worry about your diet; if ice cream is all that will slide past the lump in your throat, forget about the calories. Comfort food reigns right now. You have to sleep. Ask your doctor what you can do or take to help achieve the necessary rest. You will not get addicted to sleeping meds by taking them for a week or two. Move your body. Whenever you feel overwhelmed and upset, get up and do something. It matters less what you do than that you do it. Take a walk, wash dishes, telephone a friend. Find distractions: Watch funny movies, read trashy novels, clean your closet. Right now, unscheduled time is unhelpful.

Some people find it useful to talk with everyone about their diagnosis. They not only chat with all their family and friends, but tell the woman in the bank line that they have a new cancer diagnosis. Other people can’t say the words aloud, and find it very hard to tell anyone at all. Obviously, at some point soon, you need to share the information with the people who are closest to you, but you can decide whom else you tell. Trust your own instincts on this, and consider asking a close friend to spread the news.

You are under no obligation to share details with anyone other than your immediate family. If people ask intrusive questions, feel free to say, “I really don’t want to talk about it.” If they persist, try saying, “Why are you asking me this?” If people begin cancer stories that clearly have a bad ending, hold up your hand and literally say, “Stop.” You have full license to be as abrupt as you can comfortably be. This is a time to concentrate on taking care of yourself.

 

Hester Hill Schnipper, a licensed independent clinical social worker, is a breast cancer survivor and the chief of oncology social work at Beth Israel Deaconess Medical Center in Boston. She also manages an online breast cancer support group on the hospital’s website.