NEW CANCER DIAGNOSIS

Today in the family practice office I saw a 32-year-old female patient with the chief complaint of “migraines.” She had a previous history of migraines which had been controlled by medications. I walked into the examination room and saw a young female sitting on the examination table. She smiled as I walked into the room and introduced myself as the nurse practitioner student. I sat down on the roller stool and started to begin obtaining the history.

Dawn told me she had a history of migraine headaches which had been controlled by medications, but over the past month they had been more frequent. She told me she has had a headache every day with neck tension. She told me she had several severe episodes a couple of weeks ago with one episode causing vomiting and visual changes lasting two days. She ran out of her migraine medication and was trying Motrin with little relief. I asked her if there had been any changes in her life. Dawn started to cry. She quickly apologized for crying and I told her to not worry. I could sense there was something else behind her headaches.

Through tears Dawn told me her father was just recently diagnosed with pancreatic cancer which they believe had metastasized to his liver. He was scheduled for a liver biopsy before deciding what kind of cancer treatment options would help him. I asked how old he was and she told me 56-years-old. I could see the pain and stress in her eyes. I also could understand what she was going through during the holiday season. I lost my mom almost three years ago two days after Christmas. Once done with the history and exam I went to talk with my preceptor.

I discussed her history with my preceptor and treatment options. We both agreed she was under an incredible amount of stress that would only get worse in the coming days. It was decided to fill her current migraine medication and give her a rescue medication. I personally had the feeling she needed something more because of how I felt when my mom was dying from cancer. I recently bought Lance Armstrong bracelets because I wanted to contribute something to cancer research and survivors of cancer. I wear mine everyday to symbolize my support. I had some in my bag and decided to give one to her without my preceptor in the room. I felt it was a personal thing between myself and Dawn.

I walked into the exam room and closed the door. Dawn was sitting on the chair looking at a magazine. Her eyes were red and puffy. I knew she would have many more days of crying and pain. Pancreatic cancer usually did not have a good outcome. I walked up to her and gave her the yellow LiveStrong bracelet. She took it in her hands and looked at me with a puzzled look on her face. I told her my mother had also died from cancer around the holiday season and the bracelet was to symbolize the support of cancer research and its survivors. She started to cry once again. She looked at me and told me thank you. My preceptor then walked in with her prescriptions.

Dawn was given the prescriptions and directions on how and when to take them. As she was walking out of the exam room she thanked my preceptor and turned to me to say “thank you very much.”  

I felt I helped Dawn in a small way today. But I believe she helped me cope and proceed through my grieving process by allowing me to give her a small gift to help her through what would probably be a painful and stressful holiday season. Dawn and her family will have a long road ahead of them. The holiday season only makes the situation worse.