The Change Cycle

In the thread on AS, Casey brought up a good point of doctors needing to communicate the psychological challanges of PC. Most patients have this need and most doctor's don't address it adequately.

Research has shown that the brain reacts in the same way to change; sometimes it occurrs within a second for minor changes and sometimes it takes months to processs a major change; but it always goes through these stages;

Reptilian response: Fear, paralyzed, unable to process any information,

Mammalian: Can comprehend basic facts, but unable to integrate information into a plan

Complex: Process and integrate information and understand the entire picture.

The greater the amount of change and the less experience an individual has dealing with change will determine the time it takes to complete the cycle.

Doctors should relalize that a DX of PC, especially if it is unexpected, will be a shock and the patient will hear nothing after "you have cancer", and certaintly won't be able to process the information usually given on treatment options ect.

This is why the best advice to new patients on this forum is to take your time, gather all information and wait before making a decision, as any decision made before the brain has time to move to the complex stage will usually be a poor decision based on fear and not on a well thought out plan that considers all options and consequences.

JT

 

Could not agree more. I am thinking back to my urologist delivering the news to me: "you have cancer, it is aggressive and there is a lot of it". He then went on for another 15 min talking about treatments, probabilities, survival - I did not hear any of this. I was out of town at Duke and just wanted to come home to die. Thankfully, my wife talked me out of it. She came over and we went to see a Duke oncologist. This guy had a very different bed side manner. He understood the psychology of a patient.

This is why I ditched the first and kept the second doc.

John T, I suspect this thread has drifted a little bit from the direction you initially intended (maybe, maybe not, I don't know).  The responses have been mostly about bedside/office manner and helping (or not) patients deal with their introduction to "the big C." 

In another recent thread ("When is a PCa anniversary", https://www.healingwell.com/community/default.aspx?f=35&m=1695580), I wrote about the 90 minute meeting with my urologist which started with "You have cancer."  After that, he pulled out a blank sheet of paper and said, "I'm going to take notes for you."  As he talked through the diangosis, next steps, and an introduction to treatment options, he wrote everything down.  At the end of the meeting, he handed me the paper and told me to bring it back to our next meeting.  At the next meeting (an hour meeting, also attended by my wife), he started with a review of what he wrote.

I guess this story fits in loosely with the direction this thread is going.  Looking back, I think that was a "best practice" and helped me tremendously to retain the information that he spent 90 minutes trying to tell me (while all I could hear was the ringing in my ears).  I referenced those notes many times afterwards.

Not sure I can agree on the brain reacting to change in the same way, or the same steps, but then I am not a shrink either.

It would appear in doing unscientific obervation on this site, that most of us have reacted to change differently. Some are terrified, some are mildy concerned, some are pretty nonchalant about it. I realize that even the word "change" is a broad concept. Some of this would seem to revolve around what each of really considers as change.

In my own situation, I guess maybe I don't feel as tho much has changed , other than attaching PC to my bio. Once the incontinence is gone, yeah, sex is a little different, but at 59, it's a little different anyway. I work every day, socialize with the same friends, pursue the same interests, etc. I have done my best not to let this disease change me. Maybe I'm only fooling myself.

Our personal lives, our religous beliefs, our emotional make-up, all seem to effect how we perceive or deal with change.

Just my 2 cents worth !

Goodlife

I can buy that !

This is a great thread. As geezer99 pointed out on another thread, my husband went from diagnosis to surgery in exactly four weeks. In fact, our urologist said he would have scheduled him earlier had it not been for the holidays.
For the first two weeks, I was in sheer mourning over the diagnosis. I had already nursed a child through cancer and silly me did not think life would send something like this to me again so close to home. Like I said, silly me. Hubby, on the other hand, after about the first day of shock and some mutual emotionality, fell into stride with the "plan." I wanted to smack him at times, worrying that he was not processing this. In fact less than a week before surgery, when he locked himself in the bathroom for four hours straight and wouldn't come out, I was somewhat relieved. It's like he had to have his "dark night of the soul," to process it, take in the gravity of it. That "crisis" precipitated our communication about the upcoming surgery, what it could and would mean , the potential and expected side effects and all the details that had been glossed over. Without having that "breakthrough" I was at my wits end and truly fearful that hubby was not psychologically prepared for surgery.

Sorry for rambling here. I just think this thread hits an important point. Surgery is not just the mechanics of anatomy and disease. It truly has a deep psychological impact. Personally I think that upon diagnosis, the urologist should make a mandatory referral to a social worker or other professional experienced in this disease for the purpose of helping the patient to prepare for surgery. I wonder how many men or spouses deal with depression after surgery when dealing with side effects or recurrences. And I would think that preparation could only help.

Soulmate,

I agree that your husband needed/needs some further assistance. Hopefully you have found someone to help.

But as I said in an earlier post, we all react differently to PC. Some are able to treat it like a wisdom tooth extraction, some react much like your husband.

What is even harder is helping guys cope with no change. Like sitting on a time bomb that we have no idea when it might go off. Could be 6 months 1 year, 5 years. That is a challenge.

Best of luck to you and your husband. I personally have found my own faith hs been a tremendous help in dealing with these issues.

Goodlife