It’s about how you live


It’s ironic that I am here to celebrate National Hospice and Palliative Care Month both as a nurse, but as a patient too. I think it really is a shame that more isn’t taught about this amazing field in nursing school, or at least in my own personal experience.

I have heard of Hospice month. For some reason in my nine years as a nurse, Palliative Care month was not something I had ever heard of. I would like to share the email I sent to my wonderful co-workers to celebrate the month as my way of expressing just how important this month really is to me.

I want to take a moment to thank all of you in honor of National Hospice and Palliative Care Month. ‘It’s About How You Live.’ What we are doing is helping the patients we work with live the best life we can for as long as they can. This genuinely is a calling, and the work we do really is so important. It is funny how much your perspective changes when you are on the other side of the stethoscope and the other side of the bed. I used to get frustrated with the difficult patients I came across. Now I see myself in almost every patient I have worked with. I can empathize with their fear, their pain, and their uncertainty.

The morning of September 25, 2018 I had radiating back pain. I was supposed to have my gallbladder out ten years ago and that actually was what I was worked up for. Cancer was a purely incidental finding. That morning I was a full-time hospital bedside nurse (in women’s health, how ironic), a full-time student pursuing a bachelor’s in sociology, and a wife and mom to three kiddos. That afternoon I was told I had an ‘undetermined’ form of cancer (initially believed to be multiple myeloma). Within a week I was in so much pain from broken vertebrae that I was barely able to get out of bed, unable to eat, and my middle daughter who is a nurse’s assistant was caring for me. When I was officially diagnosed with metastatic breast cancer on October 12 I was devastated. As a women’s health nurse I knew what those words really mean and what the statistics say. The word ‘hospice’ was actually discussed and to be completely honest, I never expected to work as a nurse again which broke my heart because I love what I do and I worked very hard to become one late in life (I was 36 when I passed my boards).

When I was cleared to work again, taking a travel nursing contract in California was on my bucket list. This was something I had planned to do for a few years when my kiddos were grown. This was a chance to go somewhere new, try something new, and also consult with other doctors for my own health. I expected to come out here as a hospital nurse as I have been since beginning my nursing career. Palliative care in a clinic wasn’t even on the radar. When this was presented to me I wasn’t sure what to think, but my interview sold me on it and I was ready for a new adventure. I was incredibly nervous when I was brought on board. A new city (a huge city to boot), a new house by myself for the first time in my life (no joke, I’ve never lived alone before), a new job in a new hospital, a new charting system and a different work environment was daunting.

I want to thank all of you for your patience with me as I learned everything from scratch, and thank you for putting up with my 90-million sometimes stupid questions. Some days I felt like I was starting from scratch as a baby nurse, but you guys always were welcoming and understanding and made me feel like one of you. I had originally planned on taking a personal day on my one-year anniversary of finding out I had cancer to sit on the beach drinking a strawberry daiquiri, but I couldn’t do it. I realized I loved our work and our patients as much as you do, and I couldn’t imagine spending it any other way than in our clinic seeing patients and eating a lunch with my co-workers.

I’m going to be honest, working in this clinic is sometimes hard on an emotional level. I realize I am looking into my future and one day I will be in the same place our patients are at facing some very difficult choices. I also I know I wouldn’t change this for anything. I come home exhausted physically and emotionally every day, but I also feel proud because I feel like I have made a difference in someone’s life. I believe that what I am doing is helping people in my shoes find comfort in even the smallest ways. Thank you all for your concern whether I was doing okay with my own health (which I am!).

I’ve worked with so many doctors, nurses, social workers, and other health professionals in my eight years as a nurse but I can honestly say I’ve never worked with a group of people who are so passionate about what they do. I’ve seen how much the tough patients effect you when things take a turn for the worse, and the pleasure you take when you see the patients who are doing well. Please believe me when I say from personal experience, you change lives every day. Thank you more than you know for allowing me to become a part of that, even if only for a short time.

I have one more month with you all and I will enjoy every last day of it. Thank you for being the best part of my bucket list, and thank you for allowing me the opportunity to make a real lasting impact as a nurse every day.

Happy National Hospice and Palliative Care Month to all of you!

This genuinely is a calling. We make a difference everyday. I make a difference everyday. If this is the final stop in my career, I will view this as an amazing swan song.

Jennifer – Extensive mets to bones. Diagnosed de novo at 43 of ‘unknown cancer’ on 9/25/2018, official diagnosis of metastatic breast cancer with bone metastasis on 10/9/2018. Cancer won’t win. I won’t let it. Life’s too short not to fight for every minute.
Dx 10/9/2018, invasive ductal carcinoma (IDC), left breast, 1.5cm, Nottingham Grade 2, hormone receptor positive, ER+ (estrogen receptor)/PR+ (progesterone receptor), HER2- (human epidermal growth factor), BRACA- (genetic mutation), Stage IV, metastasized to bones
Dx reclassified 10/1/2019, IDC, left breast, 1.9cm, Nottingham Grade 1, HR+, ER+/PR+, HER2-, BRACA-, PIK3CA+, Stage IV, metastasized to bones
First CA 27.29 10/9/2018 83 (goal <38)
Hormonal Therapy 10/12/2018 Tamoxifen (Nolvadex, Apo-Tamox, Tamofen, Tamone) pills
Targeted Therapy 10/12/2018 Xgeva (Denosumab) injection
Hormonal Therapy 10/19/2018 Lupron Depot (Leuprolide Acetate) injection
Surgery 11/29/2018 Vaginal hysterectomy with bilateral salpingo-oophorectomy
First CA 27.29 post hysterectomy 12/10/2018 73 (goal <38)
Hormonal Therapy 12/11/2018 Femara (letrozole) pills
Targeted Therapy 12/23/2018 Ibrance (palbociclib) capsules
First CA 27.29 post medication change 1/10/2019 60 (goal <38)
PET Scan 2/22/2019 Breast tumor showed no appreciable FDG uptake (essentially inactive), mets to bone improved from MRI
CA 27.29 5/2/2019 39 (goal <38)
CA 27.29 6/27/2019 53 (goal <38)
PET Scan 6/28/2019 Activity in breast that suggested new or recurrent disease, activity in skeletal lesion appeared to mostly regressed slightly since prior PET scan
Surgery 7/1/2019 Left breast lumpectomy with biozorb placement
First CA 27.29 post surgery 7/25/2019 55 (goal <38)
CA 27.29 8/22/2019 46 (goal <38)
CA 27.29 9/27/2019 77.9 (goal <38.6)
PET Scan 10/5/2019 Low level uptake is surrounding postsurgical changes in the lateral left breast, with interval resection of small spiculated lesion since the outside PET scan. Mediastinum as well as the contents of the abdomen and pelvis within normal limits. The tracer localization within the skeleton is uniform and mild, in spite of the widespread evidence of lytic and blastic metastatic disease.
CA 27.29 10/25/2019 78.7 (goal <38.6)

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