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. 💕

6 Overlooked Signs of Breast Cancer

Over the last few years, and again now that my cancer has returned, many people have asked me if I had any signs of breast cancer before I found the first tumor in my breast. Yes, I did have a few of these signs, and I had pain. Please, remember to do your monthly breast self-exam and watch for these signs.

Medically reviewed by Amy Tiersten, MD — Written by Jennifer Bringle on October 5, 2020

Everyone talks about the importance of catching breast lumps as early as possible. But did you know there’s a host of lesser known breast cancer symptoms that might not show up on a self-exam or mammogram?

According to the American Cancer Society (ACA), breast cancer is the most common cancer in American women, other than skin cancers, and it’s the second-most deadly cancer for women behind lung cancer.

On average, there’s about a 1 in 8 chance that a U.S. woman will develop breast cancer at some point in their life. The ACA estimates that more than 40,000 women will die from breast cancer in 2020.

The most common form of breast cancer is invasive breast cancer, which is any type that has invaded the breast tissue.

Less common forms include inflammatory breast cancer (which is caused by cancer cells blocking lymph vessels in the skin, causing the breast to look inflamed) and Paget’s disease, which involves the skin of the nipple or areola.

With the high rates of breast cancer, the American Cancer Society recommends women have the choice to start annual mammograms at age 40. The organization says women between the ages of 45 and 54 should get mammograms every year.

And while the disease is most commonly discovered by detecting a lump during a mammogram, there are other lesser known signs and symptoms of breast cancer that women should look out for.

Nipple discharge

Unusual discharge from the nipple can be an indicator that something is wrong in the breast.

According to Marisa Weiss, MD, breast oncologist and founder of BreastCancer.org, discharge that’s bloody or pink and generally only on one side can possibly indicate the presence of cancer in the breast tissue, particularly if it’s persistent.

Skin changes

Skin changes are actually one of the most common lesser known signs of breast cancer.

“Thickness or redness of the skin, along with a little puffiness like the skin of an orange is a sign,” says Weiss. “You see dimpling where the hair follicles are, like a navel orange.”

Skin differences like thickening, dimpling, and changes in color can indicate the presence of inflammatory breast cancer.

Nipple crust

Redness, scaling, crusting, or flaking of the nipple or areola can be a sign of Paget’s disease, which can be an early indication of breast cancer.

The skin changes on the nipples often look like more benign conditions like psoriasis or eczema, but don’t respond to traditional treatments for those issues and instead worsen.

New shape or increase in breast size

An enlarged breast — particularly if the swelling is isolated to one breast — or a change in the shape of the breast, can indicate issues within the tissue.

“An unusual shape where the contour is distorted and there’s a bulge in one part of the breast can be a sign of cancer,” says Weiss.

“It could feel like a lump, but it could also just be a region of the breast that feels firmer, and you can’t really feel a lump within it,” she says. “It also often becomes more pronounced when moving in different positions.”

Inverted nipple

A nipple that looks flat or inverted, as well as a nipple that points in a different direction than it once did, can be a sign of breast cancer.

“Instead of pointing straight outward or downward, it no longer looks in the same direction, but in a different spot,” says Weiss.

A flat or inverted nipple is another sign of Paget’s disease.

Red or hot spots

Red or hot spots on the breast, sometimes covering the entire breast, can be an indicator of inflammatory breast cancer.

While red or hot spots can also indicate mastitis — inflammation of breast tissue due to infection, most often experienced during lactation — mastitis symptoms are usually accompanied by fever.

Red or hot spots without fever that persist and don’t improve can mean breast cancer is present.

The takeaway

Weiss says it’s important to remember that these signs and symptoms can indicate other benign issues that aren’t breast cancer, but it’s critical to monitor the symptoms and act if they don’t subside.

And for those who’ve already had breast cancer, it can be even more difficult to discern the innocuous from the malignant. In that case, Weiss says it’s particularly crucial to monitor changes in the breasts and alert your doctor when something doesn’t look or feel right.

“You’re always worried about recurrence of a new problem, so the ability to recognize the less common symptoms and signs may be a little trickier,” she says.

It’s sometimes difficult to distinguish between leftover scar tissue from your prior breast cancer. And if you’ve had mastectomy and reconstruction, you could have lumps and bumps in there that are due to scar tissue from all the healing where they removed and recreated your breast, says Weiss.

No matter what, Weiss advises women to pay attention to their bodies and maintain regular self-exams and mammograms. And should they notice something out of the ordinary? Let their doctor know.

Jennifer Bringle has written for Glamour, Good Housekeeping, and Parents, among other outlets. She’s working on a memoir about her post-cancer experience.

CT Guided Biopsy

A few days ago, I had a CT Guided Biopsy of my 8th rib on the left side, on my back. Everything went well; I am in a little bit of pain, but nothing that Tylenol can’t help. The doctor instructed me to rest for the rest of the day on Thursday, remove my bandage on Friday, and resume my normal activities.

After finishing my paperwork in the hospital registration office, I went to the lab to have my blood drawn for a few panels; among a few other things, they had to check my kidney function before doing the CT, and after that, I went to radiology to wait to be taken to the pre-op area.

Once my nurse was done prepping me for my procedure, my anesthesiologist came to get me and take me to the CT room. He explained that he would only give me enough medication to make me relaxed and a little sleepy but not entirely out. He said that if I did get sleepy not fight it and let myself fall asleep. I did fall asleep for some of the procedure, but I don’t think it was for very long because the process only took about 30 minutes.

When I walked into the CT room, they had me lay on my stomach on the CT table. I was shocked to find out that the lesion is actually on my 8th rib on the left side of my back, not in the front, and it is very close to my spine, so that has me a bit concerned. The rib that I fractured some 18 years ago, that I was thinking was what was showing up in my scans, was a few ribs down from where the lesion is located, so it has nothing to do with the lesion at all. So with that said, I don’t know what to expect when I meet with my oncologist next Tuesday to get my biopsy results.

I have had many people ask me what I think of all of this, how I am feeling, and what my gut is telling me. I can’t help but see the similarities to the first time I went through cancer three years ago. With every appointment, things get worse and worse, more scans, more biopsies, etc. As before, I want to know what type of cancer I have to fight against, and I want to get started on whatever treatment plan my doctors and I agree on as soon as possible so I can get this over with and move on.

I am feeling OK so far. Even if the lesion on my rib is positive for cancer, it appears to be localized like the tumors in my neck, so it is not as aggressive as it was in 2019, and because of that, I have been feeling much better physically this time around so far. Mentally I am up and down; the stress is unreal because this is the moment as a cancer survivor that I have been fearful of, having to deal with recurrence.

Lastly, what is my gut telling me? I will be shocked if the lesion on my rib is negative for cancer. After reading the PET scan report and looking up a few medical terms that I had not seen before, I immediately thought that it would be a bad result once the biopsy results came in. I, of course, hope that I am wrong, and in a few days, I will know for sure.

Oncologist Appointment & PET Scan Results

I met with my oncologist this past Tuesday to discuss the results of my PET Scan. I was shocked to hear that I have two tumors in my neck, not just one. I found them early, so they are small, 0.9 x 0.5 cm and 0.5 x 0.5 cm. So small, under 1 cm, that they usually wouldn’t have done a biopsy on them, but I had already gone to my surgeon to have the initial ultrasound and biopsy done and had received the results already. I am happy that I took that initiative and went to see my surgeon as soon as I found the tumors so that I found out sooner rather than later that my cancer had returned.

The spot on my rib is still causing concern; it has been determined that it is a lesion that was not on my previous PET Scan in 4/2019. So with the fact that it was not on the last PET Scan and the combination of findings from the recent PET Scan, they are concerned that it is a solitary bone metastasis. My oncologist ended up ordering a biopsy of my rib after our discussion. So next Thursday, I am going to the hospital to have a biopsy of the lesion done. I will have both a local drug and anesthesia for the procedure. The procedure will take about an hour, and I will be in recovery for about 2 hours as they want to keep a close eye on me for bleeding and excessive pain. Unfortunately, I have to go through this biopsy to know if the lesion is cancer or not because it could change my treatment plan if it is positive for cancer, and I then have two different locations on my body with cancer.

Because I am having the biopsy done this coming week, I cannot continue planning with my radiation oncologist at this time. It is good that she now has the images she needed to determine my scope of treatment and if it is possible to treat the tumors in my neck, but the biopsy results could change everything. The lesion on my rib is on my 8th rib, right under my left breast, so as far as I know, it is located in the previous scope of treatment done in 2019/2020.

So my oncologist and I discussed what would happen if I couldn’t have radiation treatment. As far as my neck is concerned, he doesn’t want me to have to undergo surgery, but it is a possibility that I may have to go that route. When it comes to my rib, he didn’t want to speculate on it much. I asked him if it is common for there to be one tumor in one location when it comes to bone cancer, and he said it is unusual but not impossible.

Yesterday my husband remembered that I had pain in my rib several months ago. While we were discussing it, I remembered that I mentioned it to my surgeon when I saw him for a follow-up appointment in September. I pointed to the location of the pain and told him that I felt a bump there as well. When he felt the spot that was hurting me, he said, “that is your rib,” and I told him that I didn’t realize it was my rib because I had never been able to feel my rib so easily when I weighed much more than I do now. He asked if I remembered bumping into something or hurting it somehow, and I couldn’t recall doing anything like that. So I felt it yesterday, and when I pressed on it, it still hurt, and the bump was slightly more significant. So now that I remember that conversation with my surgeon, I am very anxious to get the biopsy done and meet with my oncologist to discuss the results and what will happen next.

I know this might not be common, but it seems that my body will cause me random pain, and then I find a tumor one to two weeks later. It has happened to me three times in a row, so I can say without a doubt that I will never, ever ignore any pain I might have in the future, especially if it is around my bones. My experiences are listed below; I don’t believe that this is a coincidence anymore.

Pain in my lower neck, to shoulder, to the shoulder blade = breast cancer

Pain from my outer ear, up the side of my head, to the top of my head = breast cancer in the lymph nodes in my neck

Pain in the 8th rib under my breast = most likely more cancer, not sure of the type due to location

I will update again next Thursday, depending on how much pain I am in, or Friday about my biopsy. Thank you for being here!

I Have Cancer, Again

I received my biopsy results yesterday, and they were positive for cancer. My oncologist’s office called me in the morning and scheduled an appointment right away for today to discuss our next steps.

I was hoping that my oncologist could tell me what type of cancer I have today, but we do not have those results back yet, so I will hopefully know in a few more days. There are a couple of possibilities as far as my treatment goes, but I won’t have a definite plan until scans are done, and the results are back.

On Monday, I will be going to the hospital for a bone scan-nuclear medicine, CT neck with contrast, and CT C/A/P with contrast {ct scan of chest, abdomen, and pelvis.} If there is cancer anywhere besides my neck, we will know for sure once the scans are completed and analyzed.

On Friday next week, I will meet with my oncologist to review the scan results and my treatment plan. I do know that I will most likely have radiation therapy on my neck; anything beyond that will be determined during my appointment.

More to come…

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