1. Robbins, Kayla M. BS
  2. Silakka, Marta J. BSN, RN, CCM

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As a single mother, I hoped that my daughters Kayla and Alexa would grow up reflecting the strength, perseverance, and love for life that I spent day after day modeling for them. When they began to grow up and I saw their work ethic shine through during their first jobs and I was proud. When I saw my eldest daughter Kayla walk across the graduation stage and receive her bachelor's degree, I knew that I had succeeded in pushing her to achieve all that is possible in this life.


As a nurse, I had faith that I would pass along the importance of compassion. When my youngest daughter Alexa applied to nursing school, I became her number one supporter, giving late-night study tips and waiting eagerly by the phone for the results of the dreaded anatomy and physiology examination. One of my happiest moments being able to gift her the Littman she would go to her first clinical with.


When I was diagnosed with breast cancer, I had no doubts that the women I had raised would be there to support me; I knew this because I had already watched them thrive in hard times. I was filled with joy each time I saw a little piece of myself reflected through them and their choices. One of the things that I quickly became aware of after my diagnosis (and was both surprised and grateful for) was that my girls gained an inherent ability to take charge and handle a situation the way only the best case managers do. I watched them begin to put their own needs second when needed and use their tenacious creativity to make sure that my care came first and that nothing was overlooked. To all of my fellow case managers, I urge you to relish in the positive impact that your profession has on your peers; your resourcefulness, your sensitivity, and your ability to care are reflected through your actions each day. Your friends, family, and loved ones are better for it.


No one will be surprised when I say that cancer is not fun. The stories you have heard are true. The diagnosis is not just daunting, it is terrifying. The treatment is not just difficult, it is debilitating. But what get you through it are the people you surround yourself with. They became known as "my people." Your people lift you up, they keep tissues in their own bags for your surprise nosebleeds, they call every deli in the city to find one with the soup you like when nothing else sounds appetizing, and they square off with your treatment team when they say they can't do your surgery for two more weeks (although it proved quite successful I can't endorse the method).


I would be dishonest if I said it was all bad; the first 6 months were the worst, but things got better. From the onset, the uncertainty of everything was brutal. There were surgical and treatment options, journal articles to review, and hospitals to research. At one point, I was left to decide whether or not to have chemotherapy and was given an article based on a research study done on a group of 500 women. Trust me I know what you are all thinking. In a country where one in eight women is diagnosed with breast cancer, why I would I give this study with such a small sample size my time? Looking back, it is clear as day to me that I should have been grateful for my early detection handed the article right back to my oncologist and trusted my "nursing gut" to immediately move forward with treatment. In that moment, my mind was so clouded that the article shook me and I wasn't sure what to do. If I chose treatment, did that mean that I was choosing to be sicker? Was I voluntarily giving up my hair and a year of my life? I couldn't make sense of it, but this is where the good part comes in. I had a daughter who took statistics and was not afraid to stand up to my doctor. When I was too afraid to doubt the research, Kayla was there beside me asking the questions that I could not. I knew that I could move forward confident that I had "my people" in my corner to help me through and make sense of what came my way.


Needless to say, I began treatment a few weeks later. When my hair started to fall out, my daughters bought me scarves and made Pinterest boards full of ways to tie them to my newly bald head. I never mastered the scarf tie; it was my nemesis, so I stuck with fun hats. When chemo was getting rough, there was Kayla showing up to drive me wearing a cute hat with a matching one in hand for me. We succeeded at staying positive; the smiles, the coloring books, the funny movies, the sassy socks the nurses loved to see when I sat back in the recliner, the goodies for the other patients on the holidays, and sharing our latest Netflix obsession with the nurses while the many medications that were set to save my life slowly dripped in.


When my eyebrows fell out and I didn't feel beautiful anymore (yes it was the loss of eyebrows that really put me over the edge), both Kayla and Alexa wrote loving essays about me and won me a spot in a day of beauty and pampering for women with breast cancer and my bald head was on the front page of the newspaper looking as stunning as ever. They even had a makeup artist who helped out with that eyebrow problem. I have never been a vain woman, but cancer does a number on your self-esteem; steroids cause weight gain even when you don't eat, the hair loss, the swelling, the surgical scars, the port in your chest, and eventually the radiation burns. The day of the pampering, being dressed up and meeting local celebrities brought back the self-confidence I had temporarily lost until I got my beautiful back.


My nursing school daughter Alexa stayed closely in touch while out of state. I know that it must have been difficult to be so far away and not feel that a call or text was ever enough. I gave her assignments to feel more involved; she made "the chemo playlist" for my appointment days so that I would have inspiring songs to listen to. She snuck home once and surprised me on chemo graduation day to see me ring the famous bell in front of all the staff and patients. It was my most special day; being surrounded by all "my people," especially the ones I didn't expect to be there.


Kayla who lived local to me managed to work full-time (with overtime), attend college full-time, and never left my side during treatment. She didn't miss a doctor's appointment or a chemo session; even when others wanted to take me she always "stopped by" just to make sure everything was ok. During long chemo appointments, she may have dozed off a few times in the chair beside me after coming off the night shift at work but in a blink she was "on," reminding nurses of my allergies, arranging follow-up so she could attend with me in between work and school, and coming up with our weekly sassy social media post about what we would rather be doing other than going to chemo.


Kayla has since graduated with her bachelor's in psychology and has attended some of the Case Management Society of New England's educational seminars with me and volunteered at some of their events with me. When colleagues haven't seen me in a while they want to know my story ... you know "the cancer story." I look different from when they last saw me or they heard I wasv sick; having my daughter beside me and introducing her and hearing her tell "our story" make me not only a proud mom because it lets me hear it from her perspective but also proud of her professionally and thinking of how lucky an employer will be to have her on board as a case manager.


If you are facing cancer or any life-changing diagnosis, my best advice is to figure out who "your people" are and never face your fight alone. Keep them close. I was never alone, and I think that is why I could fight so hard even when I was exhausted. "My people" were made up of so many, and I am forever grateful to them all. But when your daughter steps up to be the case manager you need because you just can't case manage yourself, know that you will be in good hands.

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