H was diagnosed with colon cancer last year.  I thought it was tragic because the
cancer was in the middle stages and it could have been caught earlier but for her
refusal to undergo a colonoscopy for a full year.

She eventually had the procedure done and, after surgery, we had hoped she would
have no more issues.  Only time will tell.......

Things were not right though and, after evaluation for a couple of unusual lumps, I sent
her back to the Oncologist for further testing--less than one year from her diagnosis
date of colon cancer.

The Oncologist has diagnosed her with lymphoma.  He will not proceed with treatment 
because, in the process of evaluating her lymphoma, he noticed a possible mass in one
of her ovaries.  He is worried that she might have ovarian cancer separate from the
lymphoma.

She is scheduled for evaluation by the GYN Oncologist. 

She came in this past week and reports the following about her life:

She is trying not to think about the cancer and "keep going".  Weirdly, her son and his
family have moved back in with her so she can support them because her adult son lost
his job.  The family does not believe she has anything really wrong with her and keep
telling her "you'll be alright" while still living under her roof and allowing her to work and
pay all their bills.

Worse, her older sister (one of several unbalanced siblings) is also now living with her
because no other member of the family will take care of the sister who has Alzheimer's
and is also Schizophrenic.  H came home the other day to find her sister throwing away
H's clothes because she thought they were a stranger's property and needed room for
some other things.

H reports she is not sleeping well because she works at night and can't sleep during the
day because there are so many people in the house and they won't stay quiet.  She shuts
her door and even locks it but is often interrupted by a knock on the door or a call through
the closed door from her sister--"I need you to ...................".

H is quite apologetic to me because she has not been able to stop smoking (!).  She tried
the Chantix she asked for at her last visit.  This helped her decrease her smoking but she
started back up with all the stress.  I assure her that although I'd love to see her smoke
free, she has nothing for which to apologize.

After providing whatever support and treatment a doctor can provide to someone who's life
is falling apart, I left the room and stepped into my office.  I closed the door and took a few
deep breaths to regain the composure I needed to see the next patient---who came in
because of a painful hang nail......................literally.