He was in the ICU from a complication after his surgery. His journey with mesothelioma had begun just three months earlier. He had presented to his local doctor with what he thought was pneumonia- it wasn’t. Previously healthy, he was diagnosed with epithelioid mesothelioma. He and his family had researched mesothelioma, came to an academic center, had surgery. Things had been going well and then he had an unexpected complication – treatable – but unexpected.
Physically he was recovering, mentally he was devastated. He knew about the possibilities of complications since they had been explained in depth to him and he had accepted the risks of the surgery. Before the complication he was beginning to see that he and his family could cope with and live with mesothelioma. He was beginning to feel that he had regained control of his life. Now, he lies in the bed wanting to know if death was imminent.
The psychological toll that the complication had taken on him was worse than the physical setback.
As the nurse, I know that he will get better from the complication physically, I can point out all the evidence that it will happen, he is ex-tubated, his vital signs are good, he is not on oxygen, he will soon be transferred to the step down unit. All positive signs that he is on the mend.
What about his mental state? He had done everything that was asked of him after surgery, and had landed back in the I.C.U- what does that say about his prognosis? Once diagnosed with cancer, and when having treatment, finishing treatment, whether it be surgery, chemo, radiation, or clinical trial, in the back of every patient’s mind is the question, “When will I have a recurrence?” Every patient needs to process and deal with this possibility.
The way to help is to listen and support the patient. Know that everyone responds to complications differently. Point out the positives in the patient’s situation, for example, physically you are better. Acknowledge that it takes time to adjust to a diagnosis of cancer, and that there are ramifications. A cheery pep talk might not be appropriate, but simply pointing to the facts might help. Like every mesothelioma tumor is different, every patient’s reaction is different. It is important to accept that and adjust your approach.
I am happy to report that the mesothelioma patient in ICU did get physically and mentally better. He is adjusting – time, family love, and support can be the best medicine!