【Journey 06】Knowing palliative care – became stronger when I accepted everything

Hello, I’m Chico.

In the previous article, I talked about the anxiety and mental movement that I felt when I took a break after the first treatment was finally decided.

I met a nurse at a “patient meeting” that I participated in while I was not able to accept reality.

This time, I will talk from here.

Getting hospital palliative care support

Palliative care conversation with a nurse

One day when I was participating in the “Pancreatic Cancer Class & Patient meeting” held by the hospital, a nurse T approached me.

？

・・・what?

・・・・・last days?

When I was asked how I wanted to end my life, I was honestly confused and disgusted at first.

I may have felt the same sadness when my sister talked about “life expectancy”.

But as I listened to her talk, I realized that it was really good that she called out to me at this timing.

In a conversation with her:

• Palliative care will relieve physical and mental pain associated with cancer
• Palliative care begins when you are diagnosed with cancer

I learned such things.

Get to know Advance Care Planning

Nurse T taught me not only about “early palliative care” but also about “advance care planning”.

Advance Care Planning (ACP) is the process of helping patients make decisions.
To prepare for future changes, repeated discussions are held among patients, their families, close people, and the medical and care team regarding the medical care that may be necessary in the future.

アドバンス・ケア・プランニング（ACP）とは、将来の変化に備え、将来の医療及びケアについて、患者さんを主体に、そのご家族や近しい人、医療・ケアチームが、繰り返し話し合いを行い、患者さんの意思決定を支援するプロセス

出典：アドバンス・ケア・プランニング（ACP）―人生会議―｜東京都医師会

This is an effort to share one’s wishes with others in advance as to what one would like to do in the event that something happens to one’s body (assumed to be when it becomes difficult to make decisions on one’s own).

The Japanese Ministry of Health, Labour and Welfare (MHLW) has named it “Life Meeting” as a more familiar nickname, and explains it as follows

A “life meeting” is an initiative in which you think about the medical care you want in advance, and repeatedly discuss and share it with your family and the medical care team, just in case.

「人生会議」とは、もしものときのために、あなたが望む医療やケアについて前もって考え、家族等や医療・ケアチームと繰り返し話し合い、共有する取組のこと

出典：「人生会議」してみませんか｜厚生労働省

Decide in advance how to prepare for possible situations.

The idea of this advance care planning (life meeting) was very understandable for me.

By talking with nurse T and learning about palliative care and “life meetings”, my heart, which had been closed by fear, gradually opened.

Looking for a palliative care ward with the help of a social worker

As we talked about palliative care with the nurse, we came to the conclusion that we should also consider the palliative care ward.

This is because the hospital I go to has a department of palliative care, but there is no ward where I am admitted for palliative care.

I visited a social worker who was introduced by the nurse.

From the social worker, I received advice such as:

In addition, she said “palliative care wards are located all over Japan, so you can choose where you want to spend your time. However, considering the treatment and family, it may be practical to find a local hospital”.

For example, in Tokyo, you can search from the page of the Tokyo Bureau of Social Welfare and Public Health below.

Accepting it as it is made me stronger

In this way, as I talked with the nurse about “palliative care” and “how to welcome the end of life” and with the social worker about “how to find a palliative care ward,” I felt the tense threads in my heart gradually loosen.

I didn’t want to hear the words lifespan and the end

To be honest, at first, my heart was like, “I don’t want to hear words like ‘life span’ or ‘how to meet the end’! ’ screaming.

I may have rejected death and felt some sort of anger at what was happening to me somewhere in my heart.

Because I have lived my life without thinking about such things at all.

When I first heard these words, my heart was very upset.

The more I try to escape, the more fear grips me

However, one day, I realized.

That the more I try to escape, the more fear grips me.

I want to escape from problems such as fear and sadness.

But the bigger the problem, the more force it will chase after me when I run away.

The peace of mind gained by letting go of attachment and accepting it as it is

So, I accepted it.

In this way, as we embrace our fears and let go of our stereotypes..

Like this, I have become able to think flexibly and look at my own affairs objectively.

Then, strangely enough, my peace of mind returned to my mind, which had been so frightened by the fear of death in the beginning.

I may have been very lucky to understand the power of this “acceptance” early in my illness.

I feel that eliminating wasteful consumption of energy for purposes other than healing illness has greatly influenced my body’s ability to heal and the effectiveness of anticancer drugs.

Lessons learned during this period – tips for a peaceful mind

“I got cancer” “I’m scared”

From this ague anxiety, my learning began.

Write out the problem – what, why and how can it be solved?

I first went to was:

• what am I afraid of
• why am I scared

to write it down.

If I think I can improve by myself

• think of improvement

If I can’t do it by myself

• talk to others

Accept what I can’t control, don’t get attached

If something cannot be resolved or avoided, accept it.

Regardless of whether it is positive or negative, just accept it.

The point is, don’t obsess over what I can’t control (or even with the help of those around me).

Three points for peace of mind

During this period, I have learned three ways to achieve inner peace.

• let go of obsession
• accept as it is
• see my world from the outside

These three have different entrances, but I think they are one at the bottom.

Details are summarized in the article below.

Conclusion

After receiving treatment at the cancer hospital, I finally took a breather, but then my heart was enveloped in fear of illness and death.

However, through participation in the patient meeting, the support of the nurse, and my sister’s words, I was able to realize that “accepting things as they are can give me peace of mind.”

I was really lucky.

Thanks to this awareness, I can concentrate on treatment without wasting energy on unnecessary things.

In the next article, I will talk about how anticancer drug treatment progresses.