a) For those newly diagnosed:

From the first moment of shock upon hearing your diagnosis, the earth may seem to give way under your feet and a whole range of unexpected feelings may flood through you. It is natural to fear the consequences. You may want to deny this is happening to you. You may feel paralyzed when it comes to making decisions. It is not uncommon to feel as if you are at the mercy of outside forces, or pressured by the seeming certainty of professional opinions. I certainly did. Please don’t judge yourself or be ashamed of having cancer. There’s no accounting for the fact that some people who do all the “right” things get cancer, while others who are not at all health conscious get off scot-free.

Anyone diagnosed with cancer is embarking on a life-altering, bewildering, and sometimes overwhelming journey. Although there may be patterns common to all, your story will be different. It will be your own. It is important that you muster energy to become involved in your healing process, for ultimately the decisions about treatment are yours alone to make. Your health is now your top priority. Before you lies the challenge of understanding the medical and technical language of your condition and making decisions for your future health. Therein lies much growth and empowerment. Decide that you are in charge of your life, because you will undoubtedly find others—a doctor, a spouse, a friend—wanting to make decisions on your behalf, “all for the best” of course as they see it.

In the early days following your diagnosis:
* Welcome the hugs of family and friends. Let yourself be loved!
* There is no right way to handle the news. It is not inappropriate to watch TV, burst into tears, scream in your car or want to go for a long walk.
* It is a blessing to have someone close to you, a specially trusted family member, friend or counselor who is willing to listen to you, perhaps hold your hand and be comfortable with your tears, your confusion, fear or anger, if you experience such feelings.
* Trust yourself. Avoid spending time with those who try to make you talk if you don’t want to, or try to get you to stop talking if you need to.
* Once you have dealt with your initial reactions, take your time to gather information and think about your choices but also don’t procrastinate making a decision. Set a “decide-by” date to aim for. Waiting too long may not be in your best interests.
* Ask yourself “What can I do to help myself become well?” instead of worrying about questions such as “Why me?”
* Read the inspiring stories of those who have survived your type and stage of cancer. Take hope that so many, in spite of a bleak prognosis from their doctor, have courageously generated their own hope and worked towards healing.
* Write your thoughts and feelings down in a private journal as your journey unfolds.
* You may never be quite the same again. This is a life-challenging journey. Through it you may discover unexpected strengths within you. Be gentle and kind to yourself.

b) How to Get the Most Out Of Your Medical Appointments:

Prepare thoroughly ahead of time
The more you prepare for your health-related appointments, the more you will get out of them. While it is normal to feel overwhelmed, being well prepared will build your confidence. It is helpful to list in advance all the questions you wish to ask, whether your appointment is an initial consultation or a follow-up visit at any stage along the way.

Plan ahead to invite a member of your personal support team or a local advocacy group, if there is one, to go with you to help you stay focused during your appointments. It is well researched that when we are stressed, our memory is less sharp and we are more likely to space out. We may be tempted to give away our power to someone in authority and thus agree to something we would not choose under normal circumstances. That’s why having an advocate is so important.

First steps
Before you meet a practitioner who has given you a diagnosis, or from whom you wish to get a diagnosis or a test result, ask yourself, “What do I want to know?”
* Connect more fully with what you want to ask or say by taking a few slow deep breaths.
* Make a list of your questions and concerns.
* Review, reorder and regroup your questions and concerns according to the following six key categories of questions:
1. What exactly is my diagnosis?
2. What does my diagnosis mean? Or, what do the results of this test mean?
3. What are my treatment options?
4. What are your specific recommendations?
5. What is the timing of recommended treatments?
6. What about________? (List your other concerns)

* Go through the list systematically to make sure that you have left nothing out and to check if the wording could be more precise.
* Be as detailed and clear as possible. It’s your right to have your questions answered. It’s your body and your life!
* Make extra copies of the list to take with you to your appointment, one for the person accompanying you and one for your physician or health professional, if you wish him or her to have it.
* Respect the limits of what you can comfortably handle at any one time as you do this preparation. Take breaks and enlist help so that you don’t get overwhelmed.

Physicians are very busy people who are often pushed to their limits. Understandably, they may not want to take the time to get the gist of what you want to say if you waffle around, keep repeating yourself or are reluctant to give them information. Some physicians welcome a fax or email of your questions and concerns prior to a visit, especially if you are referring to something you want them to read. If you know the doctor would like to see such a list, fax it to his office. In either case, the squeaky wheel most often gets the grease, so be ready to speak up.

Excerpted from the book After Shock: From Cancer Diagnosis to Healing: a step by step guide to help you navigate your way (Roots and Wings Publishing, 2007) by Puja A. J. Thomson

© 2007 Puja A. J. Thomson. Reprinted by permission of the author. All rights reserved.

Puja A. J. Thomson is the founder and director of Roots & Wings in New Paltz, NY. Before coming to the United States, she worked as an educator and training specialist at the University of Edinburgh, and at other institutions in Scotland, in the fields of social work, education, community work and juvenile justice. Her website is www.rootsnwings.com You can also contact her at (845) 255-2278 or write to her at P.O. Box 1081, New Paltz, NY 12561