The 5 Stages of Grief That Come with a New Medical Diagnosis

Written by Aryanna Falkner

I like to share articles with you, my readers, that I can relate to and that have helpful information. No matter how I try to explain to someone what I am going through, I find that most people think of the best-case scenario or the worst, with nothing in between, which is where I feel I am presently.

The type of grief that comes with chronic illness is complex.

Grief is an experience that can completely consume you mentally, physically, and emotionally, and it doesn’t just happen with the traditional sense of loss.

In fact, going through the stages of grief can happen as a result of any major life change.

For many disabled and chronically ill people, grieving their health after a new medical diagnosis can be an unexpected challenge. The type of grief that comes with chronic illness is complex, and the cycle can often restart each time a new issue presents itself.

Here, we look at the standard five stages of grief according to Swiss-American psychiatrist Elizabeth Kubler-Ross, but through our relationships to our own bodies and what it means to mourn ourselves.

1. Denial

People who experience grief might be familiar with this first and well-known stage.

Denial, simply put, is the act of rejecting reality. Denial often comes first in the stages of grief because when a major life change occurs, the mind and body have to work to process the situation.

When you’re going through a medical complication, there are often signals that flash throughout your body to say, “Something isn’t right.” These could be flare-ups, worsening chronic pain, new symptoms, or a variety of other daily disruptions that you observe.

Even though you know logically that you’re entering a new relationship with your health when a new medical issue comes up or you get a new diagnosis, it’s common to need time to work through denial before beginning to process exactly what it is you’re feeling.

In the beginning of the grief cycle, you might deny the whole truth or just parts of reality.

Telling yourself that this isn’t really happening, that it’s “all in your head” or “not that bad,” is a way for your mind and body to protect itself from the emotional strain of grief.

You might also downplay the severity of the situation as a way to cope by:

  • rejecting pain
  • ignoring symptoms
  • hiding symptoms from loved ones
  • pushing through the health issues as though everything is okay
  • doubting yourself and the validity of your concerns

For those who don’t have chronic conditions, it might be hard to understand why denial is a common first step in processing medical trauma. Don’t we want to know what’s wrong? Don’t we want to fix it?

The answer to these questions is yes: We want to have an explanation for the symptoms and, in a dream world, a solution. But it’s not that simple.

A vast majority of chronic conditions are long-lasting and only offer symptomatic treatments rather than a cure or solution. Essentially, when you receive a new diagnosis (or if you’re still waiting on one with ongoing symptoms), the reality of time kicks in. The timeline changes.

Suddenly, you aren’t looking for a name to explain your pain, your symptoms, or your sleepless nights. Once you know what the underlying problem is, you know that the next step is to move on to treatment.

Yet, this next step can often feel impossible. And in the case of chronic illnesses, you know that this issue doesn’t necessarily have an end date.

So, to cope with this new reality — even if you’ve been waiting for a diagnosis or an explanation or someone simply to tell you that they believe you — you might enter the denial stage to try to convince yourself that it isn’t that bad. That it isn’t real.

If you’re currently in denial about your health, know that this is okay. If you’re able, allow yourself time to process the facts of the situation.

You might choose to write down a list of the facts (i.e., “I felt pain today,” “The doctor told me I had a tumor,” “I am waiting on blood work results”) until they start to feel real.

You might also decide to schedule a set time during the day to distract yourself from reality by reading a book or marathoning a show. Taking breaks is a great way to give yourself the space you need to process all the new changes in your life until they don’t feel so overwhelming.

2. Anger

Another strong emotion that you might experience is anger — at yourself, at doctors, at the world.

When anger is burning through you, it means you have most likely come to understand the reality of your situation. But this doesn’t necessarily mean that you’re ready to accept it.

Sometimes, it feels easier or more manageable to lash out at others when you’re grieving for yourself.

That doctor who didn’t listen to you sooner? The receptionist who scheduled your appointment right after a full day of work? The parking lot with no accessible spots? Their fault.

But you also might turn inward on yourself, especially if you experienced denial previously.

You might ask yourself why you waited so long to report symptom changes or why you didn’t get your medicine refilled. This can bring on a lot of self-hatred and seriously harm both your physical and mental health.

During these moments of anger, take a moment to recognize what you’re feeling, first and foremost. There’s a reason why anger is a key step in grieving — it allows you to start feeling again, as well as to examine your own feelings toward the situation.

When you feel that you’re ready to start letting go of the anger, there are different coping strategies that can help you process these strong emotions, such as art therapy, venting to friends, and practicing mindfulness.

But remember: When feelings of anger come back up as you go through the grief cycle, recognize the sensations and reflect on how they’re manifesting. Is your jaw clenched? Has your tone changed? Taking stock of your emotions can help you to reconnect with your body, especially when your body is the source of frustration.

3. Depression

Grief and depression often go hand-in-hand.

In chronically ill people, depression and other mental health conditions can also often muddle or confuse symptoms. Depression can make chronic pain worse with head, body, and stomach aches.

How do you know when your symptoms are from depression or from a different medical issue?

First, let’s note that no matter where your symptoms stem from — whether it’s physical, emotional, mental, or behavioral health — they’re valid.

Too many chronically ill people have been labeled as “attention seekers.” This disbelief in our symptoms and our bodies only makes the grieving process harder.

Know that whatever you’re going through, there’s a community of people out there who understand what you’re feeling.

That being said, it can be hard to advocate for your needs when you’re in this stage of grief. You might feel that it’s pointless to keep searching for a diagnosis or treatment. You might find yourself wishing that all of these problems would just go away.

Depression is something that often requires additional services, such as counseling. For crisis intervention, please seek out these resources on how to keep yourself safe during this vulnerable process.

4. Bargaining or negotiating

With this stage comes the “what ifs.”

What if the doctor is wrong? What if I had done something differently (diet, exercise, medicine, therapy, surgery, etc.)? What if I got into the specialist sooner?

Though this isn’t the same as denial, in which you’re trying to shut out reality, this stage might feel similar because you’re thinking of all the ways that the situation could have gone differently.

Even though you can’t actually change the past (or predict the future), negotiating with your health can be a way to process this new reality.

In fact, even after we “complete” this stage of grief, many chronically ill people still work to negotiate with their abilities as they learn their new limits. In this sense, the bargaining stage of grief is one that often reoccurs as our health continues to evolve.

5. Acceptance

The last stage of grief is typically acceptance.

Acceptance of reality. Acceptance of the pain. Acceptance of how different your relationship to your body might be now.

Research suggests that coming to terms with chronic pain can actually reduce the severity of your physical and emotional pain.

By accepting it, you acknowledge that it’s there without judgement. Then, you’re able to move forward in using coping strategies and different treatments to address the pain.

It’s important to note, though, that acceptance doesn’t mean that you have to be happy or pleased with everything that’s happening to your body and health. Acceptance does not have to mean contentedness.

You might still feel angry and depressed and overwhelmed at your situation — but this is okay.

Our relationship to our bodies is intimate, complex, and always changing shapes.

Though a new medical diagnosis or concern can restart the grief cycle, this final stage of acceptance is one that we’re always working toward.

The truth is that we don’t have much control over our bodies, which is terrifying. We can’t wish away pain or illness like blowing on dandelion puffs — no matter how hard we try or how many stems we pluck.

But we can learn to trust the cycle of grief and know that these feelings of loss are temporary. Most of all, we can practice a little self-forgiveness and self-kindness.

We can allow ourselves to be messy and mad and human.

These feelings and experiences might leave us feeling vulnerable, but through this, we find strength. In the end, we always find a way to survive.

September & October Doctor’s Appointments

I have had several doctor’s appointments over the last two months, seeing my oncologist twice, my surgeon, and having my annual mammogram done.

On Monday, September 12th, I had my monthly oncologist appointment to chat with my doctor, check my blood, and get my Faslodex injections. As far as my bloodwork is concerned, it is a little better. My white blood cell count went up a little bit from last month, so my ANC went up as well, which is good. My PA explained that my white blood cell count, red blood cell count, and ANC levels would go up and down from month to month, but it is normal, and as long as I am not too far off from a normal range, there is no reason to worry.

Friday, September 16th: I had my annual mammogram appointment. This appointment is made along with my annual check-up with my surgeon, so he orders the mammogram and then follows up to do my annual exam and go over my results. My mammogram appointments are not routine, mainly because of the scar tissue I have from my surgeries. As usual, they had to do extra imaging, but at least this time, I didn’t have to go through an ultrasound as well as a mammogram. The hospital has a 3D mammogram machine now so that they can get amazingly clear images. The tech I had was the same one I saw back in 2019, and she was very open about showing me the side-by-side pictures from 2019 and now. It was both sad and a relief to see the comparison because my tumors were very easy to see in 2019, just as it is easy to see that there is nothing in my imaging now to be concerned about. My appointment took 3 hours; as I said, not routine, but when I leave, I had my results in my hand, which was a relief because I didn’t have to wait until the following week when I saw my surgeon. All of my imaging was clear, with no sign of cancer.

Wednesday, September 21st: I went to see my surgeon for my annual check-up and to discuss my mammogram results. As soon as he walked into the exam room, he asked me about having a biopsy done on one of the ribs on my back, so I explained the imaging I had that led up to my getting the biopsy. Once we discussed what I had been through since I last saw him in February, he went through my annual exam. He said that I might have some slight capsular contracture developing in both breasts. I was alarmed by this news, but at this time, I am not overly concerned as I am not in any pain, and I can’t physically feel anything myself. But my surgeon is the expert. So if he feels something, then I believe him; he certainly knows better than I do. He mentioned a few times that I don’t have to limit my visits to once a year, so I agreed and said I would feel better if he kept a closer eye on things, so we decided to do a checkup every six months. I love that my surgeon genuinely cares about his patients and that I can fully trust him.

My oncologist appointment on October 11th was pretty routine. My white blood cell count dropped by .1, but again, it will fluctuate a little from month to month, so there is no reason to be worried. This time my Faslodex injection on the right side hurt for days. I do have some discomfort, usually in the evening after I have had my injections, but this time the pain lasted for days. I can’t explain why it hurt so much this time, but I am sure the thickness of the medicine is part of it. Unfortunately, I now dread the injection part of my appointments, but I must have them because the treatment will help keep my cancer from spreading more than it already has.

I’m sorry for the late update. I have been struggling with several things but mainly with depression. I might write about it in the future, but for now, I need to keep the details to myself. All I can say is that having stage 4 cancer is hard, especially mentally and emotionally. People compliment me on how good I look, and I appreciate that because I try my best not to look as ill as I feel on any given day. On the bad days, I stay at home because I can’t face people, and on the good days, especially days when I have little to no fatigue, I get out of the house or do a workout; anything I can do to take advantage of feeling better on that particular day.

Take care and remember, tomorrow is never promised, so live your life as best as you can. Be kind to people, treat people the way you want to be treated, and don’t judge people; you have no idea what someone else is going through, so always be kind and keep hate out of your heart. 💕

Oncologist Appointment on Monday, August 15th

So a few days ago, I had my monthly oncologist appointment to chat with my doctor, have my blood checked, and get my Faslodex injections. I know that my doctor worries when his patients lose weight, so I was quick to tell him that my hubby and I have been doing Keto for the last three weeks. He was both happy and relieved to hear the news because it explained my 7lb loss since my appointment a month ago. Overall I am feeling much better, and a lot of it is thanks to Keto. Eating fresh food 95% of the time has made a big difference in my well-being. It takes a lot of planning, and it has easily doubled our grocery bill, but we are not eating out, so the cost increase is really only due to the ridiculous price of food.

I have been posting pictures and recipes on our Facebook page, M&M Bistro Recipies, for a few years, and now I am adding some of the Keto recipes we have recently discovered as we change our lifestyle to a healthier way of eating.

As far as my bloodwork is concerned, it is a little worse. My white blood cell count dropped a little more from last month, so my ANC dropped as well to 1.3, and it should be at 1.5 or higher. There is no need for significant concern at this time, but if it continues to drop, I may have to change to the weaker dose of iBrance, which would be from 100mg to 75mg. There isn’t anything I can do to help my white blood cell count rise, so we will wait and see where it is in September and go from there. My red blood cell count is lower, but that only affects my energy level, which has not been the best but is improving thanks to eating healthier.

I have had quite a few people reach out to me recently to ask me questions about my experience over the last 3 1/2 years concerning going through breast cancer, being cancer-free, and then having cancer return. I am always open to helping others through such a difficult and confusing time as it can be with a breast cancer diagnosis. With that said, please do not hesitate to contact me, and as always, thank you for being here.

Three-Month PET Scan Results and Oncologist Appointment on July 18th

I had my first 3-month PET scan to check the progress of my tumors last Monday. As usual, I had what they call “scanxiety” from the day of my scan until today. “For people who have had a cancer diagnosis, undergoing imaging scans can lead to a variety of emotions. It is common to feel stress or worry in the period before a medical test, during the test, and while waiting for test results. We call these feelings “scanxiety.”

My husband and I met with my oncologist to get the results from my PET scan, run my blood panels, and get my Faslodex injections. My blood panels came back with several low levels, meaning they are below the normal range, but as my oncologist explained, my blood looks good for someone on chemotherapy medication, so he is happy with where I am. As far as my PET scan results are concerned, I am happy to say that I have nothing but good news! My tumors have shrunk slightly and have gone from being active to showing decreased activity, meaning they are not growing, and I have no other signs of metastatic disease, so no new tumors have been detected. 🙂 So the meds are working, and we are staying on the current plan.

So we discussed when my next PET scan would be. My oncologist said that the scans are usually in the 3 to the 6-month range. He feels that three months is too early but to wait until six months makes him nervous, so my PET scan will be in 4 months, making it in November.

My husband and I are both so relieved! It has been very difficult to deal with the uncertainty of whether the medications I am on are doing their job or not. Now we know that they are fighting my tumors, killing them little by little and preventing the growth of new tumors.

Three-Month PET Scan

Yesterday I had my first three-month PET Scan to see if the iBrance and Faslodex have made any progress in shrinking my tumors and preventing them from spreading. I was not nervous about having the scan done; unfortunately, I have had two of them before now. I am, however, anxious about the results, which I will get on the 18th when we meet with my oncologist. I need to see that they have shrunk or, at the very least, haven’t grown or spread. Seeing progress is everything to me right now because it is so hard to look forward to the future when I don’t know how I am doing.

I haven’t been writing much lately, and I am sorry about that for both my readers and me. Writing in my blog can be very therapeutic, but things have been difficult since I was diagnosed with stage 4 metastatic breast cancer. My moods can vary so much daily, and that, of course, affects everything during my day. Some days I am very optimistic, so I think about future travel and plans, and on others, I worry about my husband and what will happen when I am gone.

I can’t find the words to elaborate on anything more as I am not feeling well. I will write more on Monday or Tuesday next week once I have the results from the PET scan.

Oncologist Appointment on Monday June 20th

I was pretty wiped out when I got home from my appointment on Monday, so that’s why I am just now updating you. Each appointment is usually about 2 hours long, from checking in to leaving, and depending on how I am feeling on that particular day, it can take a lot out of me. Below is an explanation of what happened during those two hours. 

When I check in, I fill out a short form with my name, arrival time, if I have been recently hospitalized and if I have changed my insurance. I give the staff my name, birth date, and the short form. The staff person goes into a drawer and pulls a file with two more forms for me to fill out, hands me a clipboard, and they put a hospital bracelet on me. I sit in the waiting room, which is almost always pretty full, so about 16 to 18 people, both patients, and caregivers. The first form is a general form asking about any recent side effects, hospital stays, surgeries, medications, allergies, and what questions I have for my doctor. The second form is a suicide form with a few questions about self-harm and caregiver abuse. It is sad that such a form exists, but it is a reality for cancer patients, especially older patients. I fill out both forms, keep the forms with me and return the clipboard to the check-in area. This process is done every time I have an appointment.

Next, I am called back to the lab area, where I hand the tech my completed and signed forms. They weigh me, take my temperature, blood pressure, and oxygen. The tech then asks me about my pain level and if I am constipated, both common issues while undergoing cancer treatment. Last, the tech draws two vials of blood, puts them in the machine for processing, and walks me to the exam room. To give you an idea of how big this office is, there are eight doctors and twelve exam rooms.

Everything is very efficient, so I rarely have to wait longer than five minutes before my Oncologist’s PA comes in and hands me the results of my blood panels. I see his PA almost every time I have an appointment, and every other time I am there, I see both my Oncologist and his PA. On Monday, the PA said that everything looks good considering the treatment plan I am on. My white and red blood cell counts are a little low, but nothing to be overly concerned about. My ANC is low again but not too low, so hopefully, it will stabilize as I continue my treatment.

The last part of my appointment is when I go back to the chemo treatment room to get my injections. This is generally the longest part of my appointment because the medicine for my injections isn’t ordered from the pharmacy (which is in-house) until my Oncologist or PA has seen me and approved for me to get my injections, which is determined by my blood panel results. Once my nurse gets the injections from the pharmacy, she warms them because the medication is so thick, so this adds on extra time for me to wait, but it is an important step. Once the injections are sufficiently warmed, I am taken into “The Shot Room,” and I am given my injections which take several minutes due to the amount of medication. I mentioned on Monday that I have a lot less pain and discomfort after my injections if they massage the area after taking the needle out. By massaging the site of the injection, they help the medication disperse quicker. My nurse thanked me for letting her know that info and said she would pass the word on to the other nurses. Patients are often scared to speak up about even a minor issue, and it doesn’t need to be that way. I have learned to be very open no matter how embarrassed I might be because I know that after coming to see my oncologist and his staff for over three years, they want me to be open, honest, and, most importantly, not to suffer in silence if something is causing me issues. So please remember, you are your best advocate when it comes to our healthcare system!

So what is next? I started back on iBrance on Monday after having a much easier time on the lower dose. On July 11th, I will have my PET scan to check the size of my tumors. Hopefully, they will be smaller, which means that the medications are working. On July 18th, I will go back to my oncologist’s office for my monthly appointment and get the results of my PET scan. My husband will go with me on the 18th but not on the 11th. Unfortunately, I am used to PET scans now, so he does not need to go with me.

Take care, everyone!

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