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Ask Ada: Should I Tell My Daughter I Have Skin Cancer?

Plus: how do you help a family member through their grief when they prematurely lose someone?

Welcome to Ask Ada, Folks’ bi-weekly advice column for people impacted by health issues or disability. Want Ada to help you with a problem? Email Ada at askada@pillpack.com or tag @folksstories on Twitter with the #askada hashtag.

My Mom Is Isolating Herself After My Father’s Death

Hi Ada,

My father died around six months ago. Although his death was not unexpected, it took a huge toll on all of us, but especially my mother.

My mother has always kept to herself, but lately, she’s been completely isolated. She sees my brother, sister-in-law, and their son (her grandson) fairly often, and she talks to me on the phone, but I’m worried about her. She doesn’t have anyone else to talk to, she doesn’t have many hobbies, and she doesn’t have a strong community. When we talk, her affect seems flatter. Yet, she tells me she’s happy living alone and enjoys keeping to herself.

I’m worried she’s developed major social anxiety and won’t leave her house because of that. How do I help her?

-Arielle

Hi Arielle,

There’s two ways of looking at this. First, your mother says she is happy keeping her own company. If she has always been introverted and avoided social affairs, then she’s likely coping as to be expected. As you well know, grief has no set trajectory, so one moment she may be fine and enjoying the quiet of her home and the next she’ll exhibit normal signs of grief, such low energy and a flatter affect.

However, if the isolation began to manifest after your father passed away, you may have something to worry about. You’ve already picked up on a few changes, so continue to be on the lookout for signs that she’s really distancing herself from the outside world.

Grief has no set trajectory.

Has she stopped shopping and instead gets food or groceries delivered? Does she cancel doctor appointments or other commitments? Has she stopped going to church or an activity she once enjoyed? Does she seem afraid to drive or visit enclosed places, like a mall, or wide open spaces, like a park? These changes in her life and behavior tend to point to something more serious, such as anxiety, depression, or even potentially agoraphobia.

Now is an important time to increase communication with your mother. And you don’t have to do it all alone. Call in backup. Enlist your brother and his family to help. Teach her how to video chat, so she can see your face during your regular chats. Suggest your brother initiate a weekly family dinner, so your mom has access to others at least once a week.

I know you said she doesn’t have a strong community, but any positive social interaction will help at this point. If she’s religious, she may enjoy a house call from a priest or church leader.  Contact friends of hers and your fathers and encourage them to check in on her. You don’t have to make a big deal about it to them if you’re concerned your mother would be upset by your meddling — just mention that you want her to socialize a little more now that she’s alone, and you’d love for them to keep in touch with her.

If she is truly avoiding the outside world and becoming recluse, the best thing you can do to help her is to encourage her to talk to a therapist and calmly attempt to get her out of her home. The more isolation she has, the more her social phobia is encouraged. Get her outside, even if it’s in her backyard or for a short walk in her neighborhood. Attend appointments with her as a support who will ease her anxieties of being alone.

It may even be a good idea to dedicate a space to your father, such as a park bench or a brick in a new building. This will give her a special place to honor his memory and extra initiative to spend time out of her home.

Photo by Matthew Henry from Burst

Should I Tell My Daughter About My Cancer Diagnosis?

Hi Ada,

I’m lucky to exist in a teeny tiny family. It’s just me, my husband, our eleven year old daughter and both of our parents. There are no aunts, uncles or cousins, so we’re all extremely close. Well, that’s how it was last year. Almost a year ago we lost my mother and my father-in-law to late stage cancers. It was extremely sudden and they both deteriorated quickly and almost at the same time. My daughter was devastated. She went from being a vibrant little girl to a quiet, anxious one.

Here’s the problem. I just found out that my biopsies were abnormal. I have skin cancer now. It isn’t advanced, and my doctor seems very hopeful, but everything I read online scares me. I’m terrified how my daughter will react. Should I keep this from her and only tell her if treatment progresses and things get more serious? If not, how do I tell her? I’m afraid this will crush her.

Sincerely, Small Family Mom

Dear Mom —

I’m so sorry for everything you’ve experienced — and will experience — in this immensely turbulent year of your life.

I’m not sure this question has a straightforward answer. You know your daughter best, and I have limited information about her here to go on. But based simply on how she handled the death of her grandparents, my advice would be to temporarily hold off from telling her about your cancer, until you ascertain how serious treatment is going to be. My instinct is that if you only need a little outpatient surgery to treat your skin cancer, and if your oncologist doesn’t believe this incident to be much more than a blip, you’re better off sparing your daughter an unnecessary emotional trauma.

If you decide to tell her about your diagnosis, the key thing to focus on is making sure you present the information in a manner which she’s able to understand. Be calm, explain what’s happening, and tell her that you have a plan for how you’ll treat it. Reassure her that your diagnosis won’t have the same outcome as her grandparents. Then, continue to check in with her to monitor how she’s processing the news. By presenting the information in a calm, confident, and unconcerned manner, you’re projecting that everyone is safe and everything will be okay, even if you may not feel that way on the inside.

Most importantly, explain to her that nothing she did caused this.

And most importantly, explain to her that nothing she did caused this. Children often blame themselves or feel guilty after learning their parent—one of the most important people in their world—has something wrong with them, like cancer. Her world has already been turned upside down with the loss of her grandparents, and news like this may make her lose her footing.

If you haven’t already done so, find a counselor that can help your child work through her losses and process your diagnosis—if you do choose to tell her. It doesn’t matter if she is three or thirteen, the loss of integral loved ones at such an early age is something very difficult to cope with, and she likely doesn’t have the skills to do it on her own.


Are you facing a problem that is being complicated by a health condition or disability? Folks’ advice columnist Erin Ollila wants to help. Email askada@pillpack.com and tell us your problem.

Cancer

My Grandmother’s Gift As My Father Lay Dying

For #GriefAwarenessDay, the story of how a grandmother's love comforted both the grieving and the dying across two generations.

It’s the day before my father will die.

He’s in a hospital bed in the intensive care unit, hooked up to machines monitoring his vitals signs, with a light so bright hanging directly over him that I must force myself to think of things other than tunnels and what lies at the end of them.

I am 29-years-old. I am the oldest of five girls. I am a wife and a new mother.

I am a daughter so afraid of losing her father that I have convinced myself that I will not.

My Father’s Last Words

A middle-aged Latino man wearing a suit and his Latina daughter, wearing a wedding a dress on her wedding day.

My father and I on the day of my wedding in 2002.

A decade later, I often wish I could go back and tell my younger self to stay by his side and tell him I love him, because there will be no tomorrow for he and I. But on the day before my father dies, I am full of hope. I believe he will come home and we will all laugh and give my dad a hard time for so obviously needing to be the center of attention. He will laugh during this exchange, because he and I share a sense of humor. His eyes will twinkle. And we will all breathe in the knowledge that everything is as it should be again.

My mother-in-law is sitting behind me on my father’s hospital bed. She and my father always had a good time teasing and making each other laugh. I am glad for her company. My father is awake, but intubated, so having her there to bounce off my seemingly one-sided conversation provides a much-needed sense of normalcy.

She watches with me as my father blinks, opens his eyes, and focuses them above us. His eyes stay focused on that empty space for a few moments before they come down to meet mine. His lips are moving now, but the tubes make it impossible for him to speak.

I watch his lips as they move, willing myself to understand.

My Grandmother’s Funeral

When  I was 13, my dad got me a job bussing tables at the Mexican restaurant where he had moonlighted as a waiter since I was born. Every Friday and Saturday afternoon for three years, I drove with him there and back, passing the time on our 45-minute-ride to talk as father and daughter.

During one of those rides, I remember him asking me once if I ever felt like my grandmother’s spirit was still with me. He told me that he was sure his mother was watching over him and me, her only son and first grandchild, because of the special connection she had shared with each of us.

That was when I told him about Guela’s funeral.

My parents and I lived with Guela and Guelo for the first three years of my life. My grandmother spoiled me, the fiercest defender and most adoring acolyte of my toddler antics. We were so close, I called her ‘mom’ and my actual mother by her first name, Dorothy.

“Goodnight, Guela,” I whispered. It would be years before I understood I should have said “goodbye” instead

Guela died when I was six, meaning my father was just 26 when his mother died. To the funeral, my sisters and I wore the pink, puffy-sleeved dresses Guela had just bought for our portrait session at JC Penny. None of us realized we were at a funeral; I assume everybody is whispering because Guela is sleeping. It would be rude to wake her up.

Before we left, my mother lifted me high enough to kiss Guela’s cold cheek. As I kissed her prettily painted face, I thought I saw my grandmother’s lips curve into a peaceful smile. It didn’t alarm me: it’s the kind of smile I’ve seen since on my my own daughter’s face when I kiss her in her sleep… a smile caught somewhere between dream and sunrise.

“Goodnight, Guela,” I whispered. It would be years before I understood I should have said “goodbye” instead. But I truly believed she was just sleeping; that she had smiled as I kissed her.

As I told my father this, he nodded, taking in my words.

“I believe you,” he said. “She watches over both of us.”

A little Latina girl, less than a year old, posing with a bearded Latino man in glasses, wearing a 'Coolest Dad' sweatshirt.

One of my favorite pictures of my father and my daughter together.

What My Father Saw

On the day before he dies, my father desperately wants to make me understand what he sees above the bed.

He points upward again.

Sighing, I reach for my water bottle and offer him a sip. He closes his eyes in frustration, weakly shaking his head. Then he raises his right arm as high as he can and points once more. His imploring eyes find mine again; I ask if the light is too bright. He shakes his head no, raising his arm to point at it again. His lips move, forming the same shape over and over. I feel like I’ve failed him. I’m supposed to know this word, I think. The way he looks at me, the way his face falls with every realization that I do not understand tells me that I should.

I don’t know he won’t wake up again, so I should have kissed him goodbye instead.

My mother-in-law suggests I ask the night nurse for a pen and a notebook, so I leave and return, pen and paper in hand, only to discover he is too weak to write. He is only able to form the main curve of what I will realize later is a ‘G’, and nothing more.

“We should go,” she says. “He needs to rest.”

I kiss my father on his cheek, tell him that I love him, tell him that I will see him tomorrow. I don’t know he won’t wake up again, so I should have kissed him goodbye instead. Instead, I go home, climb into bed with my husband and six-month-old daughter, and dream a dreamless sleep, never suspecting I’ll never speak to my father again.

Guela’s Gift

But I know now that my mother-in-law had suspected what he was trying to say. She told me later that when I was out of the room, she asked him if there was someone he could see,

His eyes told her yes.

Guela.

The word I hadn’t understood him mouthing was my grandmother’s nickname. And by telling me he could see her during those last moments of his life, he was trying to assure me that he was right.

All these years, Guela had been watching over us.

And because she was there for him, my father could finally go in peace.

Creative Commons photo by Sarah.

Mental Health

Respect Where You’re Broken: How I Navigated Traumatic Grief

After my brother and cousin died, I was destroyed by grief. But if you work the problem, there is light at the end of the tunnel.

My baby brother Johnny died in November 2016 from an undiagnosed cardiac arrhythmia. He was 46. His death was sudden; by the time I was called to his apartment by the police, he’d been gone a week. In the aftermath, I endured hours of grief, confusion, and anxiety, as police and medical examiners scurried back and forth around me, asking me to sign documents and bear witness to Johnny’s last days of life.

Thankfully, my cousin Debi–like Johnny, another love of my life–had planned a visit to me months earlier. Less than a week later, she drove from her home in North Chicago to Westchester to help me through my grieving process. The visit grounded me, and kept me sane. We didn’t even talk about Johnny; we just went to lunch, we walked in the park, drank beer in my kitchen, visited relatives. But always, he was in the back of our minds.

When we said goodbye, I wanted to beg her to stay, just a little longer, but I knew she had to get home to her life. Then, two months later, Debi too died. It was February: one day, we were texting each other about our taxes, and the next, she was gone.

She was 57. Grief and trauma flattened me. And trauma makes grief harder to resolve.

Grief isn’t just something that happens to you: it’s a disease. And it can kill you.

Grief isn’t just something that happens to you: it’s a disease. And it can kill you. Virginia Hughes writing for Scientific American says that “persistent, consuming grief may, in and of itself, increase the risk of other illnesses, such as heart problems, high blood pressure and cancer,” as well as feelings of worthlessness, anger, and depression.

To cure my own grief, it felt like I tried every approach; some worked, and some didn’t. But I tried everything.

In the immediate aftermath Debi’s death, I contacted a local pastor: a young woman who just graduated from Columbia University. Her website said she offered pastoral counseling, and while I’m not religious, I was flattened by grief. Counseling sounded like something I could use, and besides, it was free.

I met her in a coffee shop on a snowy winter day. She was pragmatic and kind. Honestly, just opening up to a compassionate stranger about what I was going through after gave me strength. She referred me to a psychoanalyst, Dr. Smith, whose practice was housed on the church’s property, and who diagnosed me with PTSD and complex grief.

As the condolence cards appeared in the mail, I pinned them to the dining room wall. It became an ad hoc memorial, almost like a mural, to Debi and Johnny, to which I added photographs, ribbons, and dry leaves. I placed a small table beneath it, and lighting a candle, spent a few quiet moments there every day, thinking about those I’d lost.

At the same time, through an excellent online resource for the grieving, I joined a private Facebook group for people who have suffered catastrophic loss. The anonymous men and women in my group knew exactly what to say to me. There, I got the practical advice I needed: don’t try to eat full meals, buy cheese, crackers, fruit, drink lots of water, go for walks, watch funny movies, create rituals, get outside, get enough sleep.

After a while, the sessions with Dr. Smith stopped working for me, so I quit. I was too angry. I outgrew The Facebook group. But I was tenacious. As spring approached, I created a “garden” of Amaryllis plants on my window ledge for Debi, two red and two pink. I loved taking care of them. The precise morning ritual of watering them kept me grounded.

Part of me said, you’ll never get better if your best relationships are with people who are dead.

Two weeks after Debi died, her sister mailed me a ring: Debi, the queen of rings, had been wearing it the day she died. It got lost in the mail, but five months after it had been postmarked, the ripped and forwarded envelope finally made its way to me. It seemed like a sign.

Around the same time, I also had a lucid dream where a basketball shot out of the clouds, and landed at my feet. A definite message from Johnny: growing up in Wisconsin, we’d always shot hoops together in the driveway.

Part of me said, they’re still looking out for me. And part of me said, you’ll never get better if your best relationships are with people who are dead.

Last September, seven months after Debi died and 9 months after I was summoned to Johnny’s apartment, I moved to a small town on the Hudson River. In my new home, my view of the water and the New Jersey Palisades was alarmingly beautiful. I should have been grateful, but I wasn’t. My new home made me senselessly angry and frustrated:  the commute was too long, the grocery store too far, where are the bagels, what am I doing? It was a litany, an endless loop. I couldn’t stop the tape. It didn’t feel like I was grieving–it just felt like everything was wrong and broken.

It didn’t feel like I was grieving–it just felt like everything was wrong and broken.

On a rainy October morning, I arrived at my office to prep for my class. I got up from my desk,  tripped on a rug, and broke my wrist. A week later after, after a sleepless night weaning myself off pain meds, I went out for coffee.

I walked north on Warburton Avenue, which is parallel to the Hudson.  The river is always in view. It was early in the morning, the sun hadn’t come up, the sky was violet. I approached a trestle bridge that connects my neighborhood with the downtown. It skirts over a deep gorge, parallel to the blue water. I had Johnny’s black winter jacket slung over my cast.

As I walked, I heard a voice: “Respect where you’re broken.” I swear it was my brother speaking to me.

I suddenly realized how fast I’d been walking. I always walked fast, too fast. I was always in a hurry. Had I been in too much of a hurry in my grieving too?

As I crossed that bridge that morning, and heard “Respect where you’re broken”, I slowed down. I took my time. After I got my cup of coffee, instead of hurrying home, I decided to explore my new neighborhood. And this is where I found a small group of people practicing tai chi, and asked if I could join.

I’m still practicing tai chi with this group. It feels fated. I love the discipline, and the teacher reminds me of Johnny. I look forward to getting out of bed in the morning so I can join them at  8:30 a.m. in the small, gated park, overlooking the river. I like being outside, in the cold. I like the crows and the geese, and the sun over my head. It is alarmingly beautiful.

I always walked fast, too fast. I was always in a hurry. Had I been in too much of a hurry in my grieving too?

According to the National Center for PTSD, one of the “problematic outcomes [of grief] is an inability to create a new identity.” Yet creating a new identity is key to moving beyond grief, because after someone you love dies, you will never be the same person again. Yes, after losing Debi and Johnny, I had moved, but I hadn’t committed to what a life after them. I had been so afraid of admitting I had been broken that I had allowed nothing new to be created in my life.

That voice in my head changed everything. It took a year, but I finally learned that if  I wanted to create a new identity, and a new life without Debi and Johnny, I had to do things differently. I had to meet new people, and go to new places. Grief and trauma are, on some level, like everything else in life: to work through them, you need to move deliberately, have hope, and work the problem. Death disrupts the very fabric of our lives, and there are no easy answers.

Having seen my way out the other end, I want to tell anyone who has been traumatized by grief: there is a way out of this hell that you feel. But it requires patience. And, as Johnny reminded me, respect.

Creative Commons Photo by Jemsweb.