Being An Assertive Senior

This is an article topic that is a little personal for me, and one that I wouldn't have thought of just a few months ago. However, I think it is an important subject to address.

This summer, my mother-in-law discovered some bleeding "down below" if you know what I mean. From what I came to understand at that time was that this could be a common issue for aging women, caused by Uterine Fibroids - which "are non cancerous growths of the uterus that often appear during your childbearing years" according to the Mayo Clinic's definition. However, elderly women can get them as well, and is not uncommon for them.

We were thankful for this initial diagnosis - any time one hears the word "non-cancerous" the stress and anxiety goes down significantly. Her doctors, however, as part of the routine procedure in dealing with fibroids, sent a sample off to the lab for further inspection. At this time, my mother-in-law, who is now 80 years old, simply wanted to take care of it and move on with life.

To look at her, she looks as fit and as healthy as a horse (to use the old expression). She takes wonderful care of herself - she exercises, does yoga, eats extremely well (she even makes wheatgrass juice frequently, and grows the wheatgrass in her windowsill). She flies out to see our family, and her grandson a few times a year. Keeping up with her and her energy is a challenge even for me sometimes - and I am 39 year old, and in great shape (I run 6.5 miles most days - I think mom-in-law does that kind of mileage just buzzing around the house during breakfast some days!). She also still works full-time at a company she's been with for over 30 years (although now, as you'll understand in a moment, we think it's time for her to quit)!

The point is, we expected her to live into her late 90's, and it wouldn't have surprised us if she made it past 100. We are still holding out hope for this.

So, when the diagnosis of Uterine Cancer (or Endometrial cancer) came in, we were all taken aback quite a bit - especially my mother-in-law. However, at this time, around mid-summer 2010, it was diagnosed at stage 1 - which is about the best thing you can hear when it comes to being told you have cancer. At that time, according to her doctors, it was localized to her uterus, and the prognosis was good.

My wife had discussions with her mom about what the treatment would be, according to her physician - which was basically to have a hysterectomy (removing the uterus) - and all would most likely be fine and dandy from there. On further research of my own, I learned that this is a common procedure that many women have after middle age, and requires only a few days in the hospital - if that.

However, when I heard that the doctors planned on doing it in a month, that is when my brow furrowed a bit. I mean, my understanding of cancer is that if you get a diagnosis, whatever it may be - the clock is ticking - you don't want to give it a chance to spread. "Early detection is key" is a phrase I have heard many times about this awful disease. Well, if detection is key, wouldn't the procedure, or removal of the cancer **quickly** be paramount to the cure?

I asked around - my brother-in-law is a stage 4 cancer survivor, and he told me that the doctors probably had no concern of it spreading further, or they would have gotten her in there earlier. Still, I wasn't comfortable with this. If it were me, I would be on the front porch of the hospital causing a stink if they told me they were waiting a month. Cancer is a life or death issue, and to me, it doesn't matter what stage it is in. I've heard plenty of stories of missed diagnoses and people advancing several stages within a month's time - usually, because the cancer gets into the lymph nodes.

I trusted this game plan, and so did mom. She was actually relieved that it would not be for another month - that gave her time to get some other personal things done, like getting her car taken care of, errands, etc. To me, this was probably a subconscious attempt by her to put the cancer out of her mind.

Irene, as she is called, is very in tune with the "energies" of the universe - and that bad thoughts can help to propagate bad health - so her attempt to keep it out of her mind was her efforts to prevent the cancer from spreading. She is very knowledgeable with holistic approaches, and is somewhat leery of conventional medicine.

Irene went into surgery the following month, and while they were there, they took out 6 lymph nodes, as well as her uterus - all of which went off for further biopsies and testing. We were thrilled that this was done, and that she could focus on healing and getting on with her life....and we could with ours.

This was a short-lived period of relief. She received a visit at home from her doctor several days later, while she was healing, and got the news that her cancer had gone to stage 3. Five of the six lymph nodes had cancer, so the probability that it has spread elsewhere in her body is high. The uterus was completely overridden with cancer and tumors. The cancer has been labeled as 'extremely rare' and 'very aggressive.'

Thankfully, my wife was with Irene during this time.

ASSERTIVENESS

What has been gnawing at me this whole time is that it seems to me, as a person observing all of this from afar, that there has been no sense of urgency with her doctors. They delayed the surgery for a month to apparently accommodate the schedule of another doctor who they wanted to have present during the operation. It is my belief that during this month, the cancer was possibly given more of a chance to spread. It is possible, in all fairness - that she was a stage 3 all along, and that the doctors didn't realize it until the biopsy, but nonetheless, to me, any extra day that a diagnosed cancer is allowed to live in your body, especially the body of an 80 year old woman who weighs 95 pounds, is a day too long.

Furthermore, once this Stage 3 diagnosis was realized, the doctors scheduled her to begin radiation therapy "next month." Again, why are we waiting a month? I know that she needs time to heal from the surgery, but given the nature of her diagnosis, isn't this a little much. I believe she is already beginning the battle for her life, and that if too much time goes by, it will be too late for her - the cancer will have too strong of a foothold.

My frustration with all of this has been, naturally, with what I perceived as some "dragging of the feet" by her medical team. However, some of the frustration is with Irene - in that she has not been assertive with her doctors. The very first question I would have asked would have been "Why are we waiting a month" on both counts. I would have been pressing them to do the surgery sooner, and if they weren't able to comply, I would have looked for alternatives and second opinions. I have learned by talking with several other "seniors" that they perceive that some doctors treat elderly patients a little differently at times. It is uncomfortable for me to say this, but after hearing some other stories, I believe that in some cases, doctors may look at seriously or gravely ill seniors as experiencing a health condition that is to be expected with old age, and that perhaps it is just the natural progression or consequence of aging...which trumps any sense of urgency.

It is imperative for seniors to get assertive...to ask the tough questions...and to be a pain in the rear so that their questions get answered - and to put a little fire under the seat of their doctors if they feel like they are being misled or being treated as anything less than a high priority.

It is also so important, if possible, to have a trusted friend or family member go with you to the doctor - as a second set of ears, and a second voice. I think doctors "perk up" a little bit if they know that there is an extended family interest in the well-being of their patient.

I'd like to see my mother-in-law attend my son's high school graduation in 10 years. A few months ago, this wasn't even a question for me - and now, I'm not so sure. Right now, it's day to day.

I always try to write articles that I think are relevant to assisted living and seniors. This whole experience has forced my wife and myself to ask some tough questions that we hadn't considered before. Irene is now 80 years old, and starting to have some significant health problems. If she decides to go forward with radiation, or chemo - or - if she decides to do nothing, which is a possibility, will she be able to live alone any more? She's been in the same house for something like 40 years, and she does have a high degree of pride, and dignity, not to mention a fierce sense of independence. She won't consider an assisted living facility without strong resistance, which is where we ask ourselves how assertive we need to be with her? We don't live closeby, and can't care for her 24x7 for an extended period of time. We've offered to her to move to our state and live with us, but she wouldn't consider it. I can understand that her life, and her roots are all in her town, and cutting those would be to remove much of her identity. But, at some point, the reality will be that she will need help, and if she wants to stay in her town, she will most certainly have to consider an assisted living facility. I've already looked, and there are many near where she lives. By considering an assisted living residence, she'll be able to continue attending her church, maintain her long-established friendships and retain her sense of identity with the place where she has essentially spent her life.

We're all pulling for her, and we dearly love her. It's time to take the gloves off.

- by the staff at Assisted Living Directory