5 Steps to Take When Coping with Grief and Chronic Illness

This is a Guest Post by Elise

There are good days and there are bad days when dealing with a chronic illness. The fact is that you just don't know what will happen tomorrow, or even an hour from now. But, having a chronic illness or losing a friend to one does not mean there is nothing you can do to manage the pain and grief. "Manage" is the key word. How do you manage your grief?

What is Grief?

Grief is a natural emotional response to loss, brought on by loss. Small or significant, it is okay to grieve and for most people the more significant the loss the more intense your grief. How you grieve and how long is up to who you are. Factors such as your personality, life experiences, faith and your coping mechanisms all play a role.

How to Cope with Grief

Coping with grief can be difficult, so here are five first steps to take when you have a chronic illness or are dealing with the loss of a friend who you've lost from a chronic illness.

• Express your Feelings

If you don't express your feelings, you are bottling those feelings in and possibly doing yourself an injustice. This doesn't mean you need to cry on the shoulder of a stranger when sad or yell at your colleagues when angry, but, it is okay to tell a friend, family member, or coworker ho you are feeling, that you need the comfort of someone near you, or to be left alone for some time.

• Take Care of Your Health

Turning away from your health could mean no longer exercising, eating poorly, or losing routine in your life. Both physical and mental health can be at risk during your grieving process, so taking time to focus on your health is important. One way to start is by creating a nighttime routine such as a bath or shower, prepping your clothes for the next day and reading a book to fall asleep. Adding small things such as essential oils, calming music or even adding breathing and meditation to your routine are great ways to relax your body and mind.

• Understand the Inevitability of Bad Days

Bad days are going to happen. You may wake from a restless night, be plagued with difficult thoughts, or you're just having a bad day. All of these are legitimate, and when grieving you will inevitably have difficult days. Understanding that these days will occur will not make your grief fall to the wayside, but you will know that tomorrow may be better.

• Don't Forget - Moving on Doesn't Mean You Must Forget

A common myth about grief is that if you try to move on you must forget. If you lost a friend, it means you should put thoughts of that friend aside. If you are coping with a chronic illness this might mean you should forget the good times before your illness. This simply is not true. There is room in us to both manage the grief as well as remember our loss.

• Seek out Support

Support groups, therapy and confiding in someone you trust are not easy to do for many people. When you grieve these can be even more difficult. However, knowing that support is available to you is important. Understanding that you are not the only one (often the case when grieving) can be encouraging and help you cope with your emotions and pain.

Grief will affect everyone at some point in their life, but when dealing with a chronic disease, yours or that of a loved one, your grief can take longer to manage. However, it is important to know that there are coping solutions to help you keep yourself moving forward.

Elise is a freelance writer located in North Carolina that regularly covers health and wellness topics for Mattress Advisor. She is especially passionate about understanding and researching mental health and loves to educate others on the topic through her writing.

A Look at Caregiving

This is a Guest Post by My Father

My daughter asked me to write about my experiences as a caregiver to herself and her mother. It made me contemplate for a while as I really don't consider myself a caregiver. In my heart, I am just a husband and father doing what those roles routinely require and the fact that my wife and daughter are chronically ill is just another dimension to my husband and father roles.


Cambridge Dictionary defines a caregiver as "someone who provides for the needs of people who are ill or can't provide for their own needs". So, okay, I guess I am a caregiver even though I consider my role more of that as a husband and parent. I don't consider providing health related service to my family any different than changing diapers for my daughter when she was a baby, it's just one of those things you do. My wife is fond of saying "You do what you need to do".


I also provide service for my wife and daughter beyond their illnesses wherever they need support. For example, my wife required a new car battery. I completed the task at hand as she was in need of assistance and she has a weight lifting restriction. I tend to categorize my service as things that need to be provided because I am the best source not because of their chronic illnesses. I complete certain tasks that are beyond their individual skills or abilities, it is more than I expect them to do. They are health related although I didn't consider the health portion in my willingness to complete such tasks.


A lot of routine husband and parent duties are health related but a lot are just duties that aren't necessarily required because of chronic illness and others cross categories. I complete required maintenance of our homes as well as medically required tasks such as my wife's daily eye drops, transportation to medical procedures, or picking up prescriptions. My daughter was on TPN for a while during her high school years and my wife and I were both taught how to provide care for her central line and feedings. It became a priority item in the daily routine and we tried to make it a fun activity and family bonding time rather than a time of an unwelcomed dreaded chore.


When we first realized that my wife would be facing a life time of health issues related to her Familial Polyposis and Type II Diabetes diagnoses there was concern on my part about the amount of daily time this would require of myself. In retrospect, it hasn't been much different as the extra work involved became part of being an actively involved family member. There are always things that need to be accomplished on a daily basis and the health related items fit into normal daily activities quite well. It's all part of being an active family member.


Chronic illness is a day by day process that can bring a lot of frustration, anger, depression, and angst for the patient and the family. Being the regularly healthy one in our family trio means that I need to just be a stable, dependable source for the needs that arise on any given day. It may be a comforting hug, a kind and supportive word, a ride to the ER, or taking out the trash and preparing a meal. Because my health is stable, I can provide such services as a caregiver with little burden or difficulty.

An attitude of welcoming the opportunity to serve rather than resentment of each chore is an essential ingredient in creating a healthy, mutually respectful and loving relationship between caregiver and recipient. Using the time to strengthen bonds, deepen the relationship and draw closer together instead of letting it draw apart and create barriers. Chronic illness is generally no one's fault, it just is; it's something to learn to live with as best as you can regardless of your role. We live day to day, appreciating the good days that are available to us. Being supportive, encouraging, willing and happy to serve, being a support that can be depended upon regardless of the time or day. Instead of considering the extra health related duties as unwanted chores, consider them an opportunity to serve a loved one and perform that service with humility allowing it to be a time of comradeship and an enriching quality time.


Being helpless to improve the situation, feeling guilty as the healthy individual and they aren't, being stretched and stressed can be a daily issue for a caregiver. Utilizing those healthier times to enjoy life together helps to relax and unwind, to reflect and re-group for one's physical and mental well-being is important. Being thankful daily for where you are at this time and place is a good way to quantify the caregiving role and the rewards that are received in performing service to others. Because at the end of the day, as my daughter reminds me with her request for this article: I am a caregiver and I'm honored to have such a role.

Dialectical Behavioral Therapy for Chronic Pain

This is a guest post by Danielle Faith

In Pain at 4 am

I've just woken up. It is 4 o'clock in the morning and I am in extreme pain. I'm doubled over and unable to move. My goosebumps have goosebumps and I'm ready to pass out or vomit from the extreme pain. I know I have to go to the ER and it's causing a ton of stress.

I have asked myself countless times what if there was a way to avoid a panic attack? What if I could handle the stress better? What can help me? Could it help me avoid the Emergency Room? Can I make my situation more comfortable?

Does this sound familiar to you? Have you ever asked yourself these questions or wished you could manage stress better? What if I told you, you can make things better? It is moments like these where Dialectical Behavioral Therapy (DBT) can help lower your stress and anxiety, allowing you to make clear headed decisions about how to handle your health and can even reduce pain. This is because pain and stress can be intertwined. When you're stressed, you are in more pain and more pain equates to more stress. DBT helps break this cycle and gives you a chance at de-escalating the situation.

What is DBT?

Dialectical Behavioral Therapy (DBT) is a behavioral treatment method originally created by Marsha Linehan to treat a wide range of psychological disorders such as depression, borderline personality disorder, and suicidal idealizations. Over time, it has been proven that DBT is also effective in helping patients handle chronic illness as well and has been used to lower anxiety in chronic pain patients. DBT focuses on a set of four behavioral skills:

1. Distress Tolerance Skills
2. Interpersonal Effectiveness
3. Emotion Regulation
4. Mindfulness

Distress Tolerance

Distress Tolerance Skills are used when the situation cannot be changed. Each skill offers difference insight and it is important to use the right skill at the right time for maximum success. These skills are designed to help you cope and survive during crisis and can be applied to both short term or long term emotional and physical pain.

   Personal Example of Distress Tolerance

Radical acceptance is one of a few distress tolerance skills a person can learn. It is all about recognizing what you can and cannot control. For instance, at one point during the course of my illness I had to live with a feeding tube. Having that tube in my body was the strangest thing. I hated it. However, as time went on I began to accept it for what it was in the moment. That didn't mean I liked the situation.

I actually disliked it quite a bit. But having radical acceptance about it allowed me to relax and recognize that this is just how things are right now. It isn't forever. Figuring this skill out made me feel so much better about my illness. Plus, I was right, the tube wasn't forever, because I had it removed last year and have been much better since.

Interpersonal Effectiveness

Interpersonal Effectiveness skills apply to the skills that help us attend to our relationships. It is about balancing priorities and demands. It is about balancing the 'shoulds' and 'wants' to build a sense of mastery. These skills help identify what we need to do in order to get the results we want out of an interaction while maintaining a sense of self-respect.

  Personal Example of Interpersonal Effectiveness

Many times I've ended up in the ER and have had to use a specific format of talking to get the care I needed at the ER. The skill I'd use is known as "DEARMAN":

Describe: the situation, "Doctor, I've been vomiting all night and am in a lot of upper right abdominal pain."

Express: your concerns, "I'm very stressed out. I think I'm having a pancreatitis flare."

Assert: yourself by acknowledging what you need, "usually Benadryl, Zofran, lot of fluids and pain medication help the situation. I may also need an admit depending on my blood work."

Reward: the person and tell them what they get out of the situation, "I really need your help to make me feel better, that's what doctors do best!"

Mindful: of what is happening and/or repeating your needs, "So, when you put the medication orders in don't forget to include the Benadryl; that's important or I'll itch from the pain medication."

Appear: effective and nice, "I understand what you mean doctor. I am, however, in a lot of pain."

Negotiate: alternative solutions, "I'm willing to try an anti-inflammatory first. But if that doesn't work, can we make sure there's pain medication ordered as well? Thanks!"

Emotion Regulation

Emotion Regulation is the ability to respond to a variety of scenarios in a manner that is socially acceptable yet flexible enough to allow for genuine reactions. Being able to control how you react to a situation is essential when it comes to managing how you might be impacted by a situation.

  Personal Example of Emotion Regulation

One day I was feeling sad about my chronic illness. I was telling myself I looked fat and was lazy. I felt really bad about it too. I really just wanted to check out and take a nap. That's until I went ahead and changed my thoughts which influenced my feelings and behavior. Instead of telling myself something negative, I went for something more positive. Instead of saying I was fat and lazy, I told myself I was chronically ill and doing my best. That made me feel a bit better and I felt a lot of empathy for myself; then I was able to get up out of bed and start the day.

Mindfulness

Mindfulness applies to distress tolerance, emotion regulation, and interpersonal effectiveness skills through observation. By observing what is going on around you, this allows you to fully engage yourself in the experience without labeling it as good, bad, or anything in between. The benefit of mindfulness is that it quiets your mind and gives you a way to acknowledge all your thoughts and feelings.

  Personal Example of Mindfulness

I was really stressed out about being sick and having a feeding tube that I just broke down. I started to cry with no judgment. Before I knew it, all the stress I hold in my neck, shoulders, and back evaporated. It was like magic. Suddenly, as I noticed the lack of pain in my body, I stopped crying in awe. For two days I noticed every little thing about not carrying that weight on my back and ended up having a really great two days.

DBT for Chronic Pain

As you can see, DBT brings a lot of hope to chronic pain sufferers. This is because chronic pain and anxiety go hand in hand. Treating anxiety is one easy way to lower the intensity of a person's pain. While it may not fix the root cause of pain, it can allow a person the freedom to make intellectual decisions about their care that isn't influenced by anxiety or fear. This alone can unlock doors for those with painful conditions. 

You're Not Lost: How to Find Yourself When Life Takes a Detour: Amy's Story

This is a guest post by Amy Oestreicher

Sometimes, the best way to find yourself is to just get lost. When you don't know where you’re going, the world can be a scary place. That’s what drives our to-do lists, our calendars, our goals and our life plans. I know this all too well, as someone who had a minute-to-minute agenda, planning and plotting every major milestone in my life from birth to bachelor’s degree to Broadway debut. But sometimes, life takes a detour. Something that a 2016 yearly planner can’t always account for.

What’s a detour? Google has an answer for that:

noun 1. a long or roundabout route taken to avoid something or to visit somewhere along the way. "he had made a detour to a cafe"

verb 1. take a long or roundabout route. "he detoured around the walls" A detour, according to its French origins, literally means a change of direction.

I, however, have my own definition of a detour:
A detour is a curve in the road of life, a bump in a path, a big sign in the middle of your trip that says, “sorry, you have to go THAT way.” Nobody expects a detour to happen in life. It’s what happens when we think we have things planned and all figured out…and then we’re thrown a curveball.

A detour is many things – unexpected, a nuisance, difficult, hard to grapple with, frustrating, – but it can be beautiful. Sometimes, we can’t appreciate how beautiful our detour was until we’ve made multiple twists, turns and deviations in our “set-out” path. Sometimes, we can’t realize the beauty of our detour until we spend a bit of time traveling it – we need to give that detour enough time to form a story of its own. After all, every good story comes from a detour. What would be so funny about a forum if “A Funny Thing [never] Happened on the Way to the Forum? (It’s a musical, FYI.) By sharing our stories, we make sense of our “detours.” We reframe our “derailments” as the intricate pathways that make up who we are today. When we tell others about our detours, we become travel partners on these journeys with no straight path. When we know we’re not traveling alone, that road becomes an adventure. Who can say they’ve never had an unexpected glitch in their life-plans? That’s a detour.

What detours force us to do is explore new opportunities. When we can’t go in the direction we anticipated, we’ve got to switch gears and adapt. We have to resource inner strengths that we never knew we were capable of accessing. When we achieve the “unthinkable”, we discover who we really are. Even still plagued with wounds, scars, and some medical issues that haven’t been resolved, I’ve found beauty in the detours. If I took away all of the setbacks, hurdles, frustrations and detours, I wouldn’t be who I am today. Telling my story made me realize the true beauty of my detour. That’s what makes me a Detourist.


What’s a Detourist? A detourist travels along detours – simple enough. But in addition, a detourist embraces those unexpected routes as opportunities for growth, change and self-fulfillment. I’m living proof that a detour can lead to unexpected blessings. As a detourist, I look for the upside of obstacles. I welcome the unexpected change in my “thought-out” life, and see what opportunities may arise.

Because of my ten-year surgical marathon, I’ve written a one-woman musical about my life, Gutless & Grateful, I discovered the world of mixed media art, I've met amazing people, discovered incredible new experiences, and have been through the worst to make room for the best. Starting a Movement How do we make the best of a detour? Sometimes, we just need to hear that other Detourists have navigated their paths triumphantly. What I’ve experienced is, the more inspiring stories we hear about Detourists turning an obstacle into an opportunity, the more empowered we are to transform our own lives and have confidence that when life DOES surprise us, we’re capable of getting through anything. #LoveMyDetour Now, I want to inspire people to flourish because of, rather than in spite of challenges.#LoveMyDetour aims to encourage growth and healing by sharing our stories; to transform communities by inspiring people to open their minds and reframe their view of “detours” into a new direction for life. That’s why I’m spreading #LoveMyDetour around the world.

With that in mind, I’d like to leave you with six ways to love your detour: 1. Savor the element of surprise. Straight paths are boring. 2. Find one beautiful flower along the path and name it after the detour that led you to it. 3. Keep traveling to see where it leads. 4. Find a new friend along the path. 5. Use it as a chance to locate your internal compass. 6. Put the pedal to the metal and take the best road trip of your life! So how do you get un-lost? You know how you realize you're normal once you realize NO ONE is normal? Well you get un-lost when you realize were all detouring together. If we keep going, we're not lost. We're Detourists. Thriving Through Detours #LoveMyDetour is a campaign inspiring people to flourish because of, rather than in spite of challenges. #LoveMyDetour aims to encourage growth and healing by sharing our stories; to transform communities by inspiring people to open their minds and reframe their view of “detours” into a new direction for life. “Detours” have created the most scenic surprises in my world. Now, I envision a world where “detours” in life are everyday blessings. The road is open with open possibility, with voluptuous curves, with wandering wonder. Safe travels, Detourists!

 Learn more about creating compassion through our detours at amyoes.com.

Amy Oestreicher is a PTSD peer-to-peer specialist, artist, author, speaker for RAINN, writer for The Huffington Post, award-winning health advocate, actress and playwright, eagerly sharing the lessons learned from trauma through her writing, performance, art and speaking. As the writer, director and star of the Gutless & Grateful, her one-woman autobiographical musical, she's toured theatres across the country, earning rave reviews and accolades since it’s BroadwayWorld Award-nominated NYC debut. As a visual artist, her works have been featured in esteemed galleries and solo exhibitions, and her mixed media workshops emphasize creativity as an essential mindset.

Amy’s “beautiful detour” inspired her to create the #LoveMyDetour movement, a campaign inspiring people to flourish because of, rather than in spite of challenges. As the Eastern Regional Recipient of the Great Comebacks Award, Amy has spoken to hundreds of WOCN nurses on behalf of ostomates nationwide. She is a regular lifestyle, wellness, and arts contributor for several notable online and print publications, and has written for over 50 online magazines and blogs. on Her story has appeared on the TODAY Show, CBS, Cosmopolitan, Seventeen Magazine, among others.

Amy's passion for the arts as a means of healing and expression led her to devise storytelling workshops for the Transformative Language Arts Network National Conference, the Eating Recovery Center Foundation, and The League for the Advancement of New England Storytelling.

Determined to bridge the gap of communication between wellness resources on college campuses and students, Amy is currently touring college campuses with a program combining mental health advocacy, sexual assault awareness and Broadway Theatre.

For information on keynote presentations, private coaching, workshops and signature talkbacks, visit amyoes.com and follow her on Twitter Instagram, Etsy and Facebook.

Chronic Illness Teaching Moments: Tracy's Story

This is a guest post written by Tracy Dee Whitt.

I'm sitting in an Ear, Nose, and Throat doctor's office waiting to get a thyroid biopsy. Familial Adenomatous Polyposis (FAP) is a scary disease, it takes so much away from me and my family.

I was asked about what I've taught my children about my health and health issues. I pondered this question more as I sat in that ENT office, waiting again for a test which results may change my life again. How do you tell your children you have a deadly disease? How do you explain to your kids once again why you can't walk through the zoo, today you can't jump rope or play soccer in the yard, why you can't eat their favorite food, why you can't do so much that every parent should be able to do?



The Whitt Family - No Ordinary Family

I don't tell them everything at once, I break it down, and I don't give the doom and gloom tidbits that crawl through my mind weekly (if I'm lucky).

Before sharing how I tell my kids about my disease, I need to explain a little about my family. We're different. First, we adopted both of our children, Jeremiah is 5 and Payton is 7. Because of adoption my children won't inherit my disease, which I'm extremely grateful for. If my children were to inherit my disease I would make different considerations when educating them, so for this post I'm coming from a different angle than some who will read this.

Another factor that makes our family different is our son, Jeremiah, has autism. He doesn't understand my illness and wouldn't if I explained it to him so for this post I will only be talking about my daughter, Payton, and how I've shared with her about my disease and how she's dealt with it.

I had my colon removed when I was 18 years old (I'm now 36). The removal of such a large organ has caused some issues for me and thus we've talked to Payton a lot about the result of not having a large intestine. (I say 'we' because my husband is very supportive and helps to share with Payton about what I can and cannot do, why my body is the way it is.) This has led to discussions about my disease. 

I tell Payton that I've had my large intestine removed because if I hadn't, I would have cancer. I haven't really explained what cancer is to her because I feel it would cause her to worry too much. She knows her great-grandma died of cancer (different from what I face because this grandma didn't have FAP) and Payton's intelligent so I'm sure in some way she's connected some dots. Frankly, she probably avoids asking too much because she knows the end results of the word 'cancer'.

When I get tests done, she knows about them and knows what they're for. Although she doesn't know the scope of everything, she's aware that mommy has a disease and life is different because of it.

We try not to make life too different, but having this disease and adding a child who has nonverbal autism, life is going to be unique. We try to make it as normal as possible. We are very family-focused and we try to tailor our adventures to fit everyone's abilities.

I've also really focused on getting all I can out of my good days. I only have so much each day and there are days when I don't have anything at all - I'm exhausted and in pain. On the good days I try to spend quality time with my kids. I take them often to hug, hold them, and do any activity with them they enjoy.

Overall, Payton is empathetic to how I feel but there are times when she gets tired of not being able to do something because I'm sick or because I'm sleeping. There are many times I feel guilty because I have this disease, mainly because of how it's affected me. I get so frustrated and a large part of that frustration is around what I can't do with, or for, my family.

So, how do you tell your child about your serious rare disease? It's hard, I don't know that there's a simple way to go about it, especially when it's a disease that's trying to take your life with every breath you breathe. Cancer conversations are horrible to have with children. I think the best way to go about it is slowly and simply, making terminology as simple as possible and leaving out the catastrophic information as long as you can without shutting your child out completely.

I believe that when a parent has a serious illness it can create a compassionate child. I've seen this in our daughter, but more so because of her brother's autism, and this is probably because it's something we live with daily. Many conversations center around Jeremiah's disABILITY.

Because of living with autism and having open conversations about it, Payton has become an awesome advocate for special needs. She is extremely accepting of people who are different and so loving toward others. She is also very helpful with her brother even when I don't ask a thing of her. She knows. She has an innate ability to understand that I need help with Jeremiah and she goes out of her way constantly to assist him. I think so much of who she is stems from having the family she does (both because of her brother's autism and my illness). We explain and openly talk about so much and we are also very supportive of one another.

The family I grew up in treated this disease far differently and in the end it wasn't the best for me. This disease has killed several of my extended relatives including my Grandma, she passed at age 47 when my mother was 22. My mom saw this disease take her mother in such a horrible, unthinkable way, yet she put it under the covers and didn't face its reality. She didn't have a colonoscopy until she was 39, she's extremely fortunate she didn't have cancer and the doctors were able to remove her colon and she's still alive at age 62.

However, this approach of blanketing it and not facing reality caused me to not see what could happen to me. I lived in a sort of utopia. I knew I needed to get regular colonoscopies but I didn't really understand the full devastation FAP can cause. I skipped those colonoscopies for years, probably due to my mom being fine when she was 39 and not having any other complications. I didn't understand that it's not as simple as removing every polyp. I didn't realize how fast this disease can escalate. There was a lot I didn't know. Open communication and further learning could have helped me know what to watch for.

My mom never wanted to talk about her mother's passing, in fact, it affected her so much that she hardly ever spoke of her mom, even the good times. Her death had wrenched my mothers heart so much that she wasn't even able to talk about her. Because of this I never learned about my Grandma, what she was like, what she loved to do, what her best qualities were. Nor did I really know how FAP had taken her. I didn't need to hear every detail at age 15 but as I saw my 20s passing it was something that should have been talked about. I needed to know what I'm facing.

There are some benefits to me living in that utopia but more information would have been better. For example, there's a good chance I wouldn't have done foster care or adopted a special needs child if I'd known what I know now. However, I'm so glad I did, it's been the best decision I've ever made.

These conversations are difficult and so much more for parents who have children who inherited this disease. Take it one step at a time and know that none of us are going to do it perfectly.

Tracy Dee Whitt authors the blog LovinAdoptin, encouraging and supporting adoptive and foster parents as well as those living with autism. She can be found on Facebook, Twitter, and Pinterest.

Navigating the Road of FAP: Jamie's Story

This is a guest post by Jamie Klapper

Familial Adenomatous Polyposis (FAP) has been a major impact on my life from the time I was very little. My mother and grandmother both had this condition as well as me. From the time I was little, I remember my mother going to doctors and having a lot of procedures. The turning point that FAP became the most evident is when my mother had her whipple procedure due to duodenal cancer and almost died from the complications. I was 9 and I spent a month of my life watching her struggle to live. She developed Adult Respiratory Distress Syndrome, fluid built up in the air sacs in her lungs reducing the amount of oxygen in her bloodstream, and was placed in a medicated coma, she stayed in the ICU unit for three weeks. I wasn't allowed to visit her during this time and my mother's cancer diagnosis was not fully disclosed to the family until later in the cancer's progression. Due to the risk of losing my mother and the prolonged separation from her, I experienced severe separation anxiety upon her return home from the hospital. My mother underwent chemo for the duodenal cancer and survived.



Jamie sporting her FAP Awareness Shirt
and I Am Strong Socks

During high school, I was officially diagnosed with FAP via blood test. The one thing I remember was the doctor asking me if I understood what he was saying, my first thought was "Yes I do, I'm not stupid". During high school, my diagnosis was kept a secret from everyone to honor my father's wishes. My father is a very private person and he felt this was a family issue that was not for everyone else to know. For the first few years after diagnosis, only a few very close family friends knew. Due to the privacy of it, I always felt that it was like I did something bad. I decided when I went to college things were going to change and FAP was not going to be such a hush-hush topic. I realized I had not done anything bad and FAP was just a part of me. I wanted to be able to have support and knowledge with the FAP, I didn't want to have to sneak around anymore. It had become difficult to come up with excuses for missing school for procedures, particularly colonoscopies due to the extra time needed for a prep day. Freshman year of college I became more open, explaining that I had a genetic disease and what FAP did and how it affected me. It felt so great to have this in the open and no more hushing around. I finally had friends who I could talk to and who could understand my struggle. I would need this support more than ever as it was during this year that my mother's cancer returned in her stomach and she was undergoing surgery to remove her stomach when liver cancer was discovered and the surgery was halted. She underwent chemotherapy a second time but did not survive the cancer this time. One of my hardest struggles has been losing my mother and grandmother to FAP, they were both very strong women who meant a lot to me. I now realized I was fighting a monster. I felt defeated without her and since her passing I've experienced a number of my own health struggles.

In 2006, I had a total colectomy with reconnection. The change from pre and post surgery has been a lot to adjust to. Right after the surgery I had every infection you could think of and I spent several days in the hospital. I returned to college going to the restroom up to a dozen times a day. I student taught and graduated from college. Since that time I've developed growths on my liver requiring close monitoring, liver embolization therapy to reduce or block the blood flow to cancer cells in the liver, intestinal obstructions, and severe chronic abdominal pain. FAP has greatly impacted my life and primarily so by taking away a normal life for me. It has been difficult that at the age of 24 I had to stop working due to the severity of chronic pain and the complications I've experienced, including frequent bowel movements requiring immediate restroom access or risk accidents. I now spend my days in doctor offices and taking medications to manage my health. I watch my friends having fun and starting families and this will never be my reality. Friends and family tell me how strong I am but I feel like I'm fighting everyday just to make it through. I mourn the life I thought I would have.

In spite of the struggles I've discovered a number of ways to help cope and live with FAP and the complications. Support in person and online have been very beneficial. I have regular counseling sessions with a social worker and enjoy various online support groups for FAP and chronic pain through Facebook. Most importantly, being open with others about my experiences rather than bottling up my experiences and feelings has made a difference in addition to raising awareness of FAP so that others down the road might have a less difficult time.

Jamie Klapper is an active member of FAP and Chronic Pain Facebook Support Groups. Like many of those with Familial Adenomatous Polyposis, Jamie witnessed the effects of FAP on her family prior to having her own experiences. Navigating through the terrain of FAP on the body and mind is never an easy task. Jamie discovered the importance of social support throughout the journey and the difference it makes for one's survival.

A Mission for Early Cancer Detection: Daniel's Story

This is a guest post by Daniel Shockley

My name is Daniel Shockley, I reside in Hawaii and retired at age 43 from the Navy in 2003 after serving 22-years on active duty. My last three years were spent while deployed to Middle East in direct support of OPERATION ENDURING and IRAQI FREEDOM. Fast forward to May 2012, I underwent my first colonoscopy that was scheduled at age 51. The procedure was performed by Dr. Fernando Ona of the GI Clinic at Spark M. Matsunaga Veterans Affairs Medical Center, Hawaii. Approximately 100 polyps were discovered throughout my colon, rectum, and anus. A large mass was found in my ascending colon causing an 80% blockage. Based on these findings I was immediately referred to Susan Donlon, Certified Genetic Counselor, Tripler Army Medical Center (TAMC), Hawaii.  It was suspected I may have a gene mutation which can be confirmed by DNA testing.  The DNA samples were gathered and sent to a molecular oncology laboratory in California.  Approximately three weeks later the results arrived and revealed the rare gene mutation, Adenomatous Polyposis Coli (APC), which is an inherited disorder best characterized by the development of a myriad of polyps in the colon. These findings confirmed the diagnosis of Attenuated Familial Adenomatous Polyposis (AFAP), which is a variant of Familial Adenomatous Polyposis (FAP) that can best be characterized by fewer colorectal polyps (commonly 10 – 100), later age of onset of polyps (mean age of polyp diagnosis, 44 years), and cancer (mean age, 56 years).



Daniel and Dr. Henry Lynch

It should be noted, Dr. Henry T. Lynch, Creighton’s Hereditary Cancer Center, Department of Preventive Medicine, is credited with the discovery of AFAP. Additionally, Dr. Lynch is one of the founding fathers of genetic research. There are currently no statistics on AFAP. However, it is estimated that <0.03% of the global population have this condition.

Upon receiving the diagnosis of AFAP, Lt. Col. Ronald Gagliano, Chief, Colon and Rectal Surgery and Director, Surgical Research, TAMC along with Susan Donlon, informed me surgery was inevitable, as there is no cure for AFAP.  It must be noted leading up to the confirmation of AFAP and prior to the colonoscopy, I considered myself to be in good health with no indications of any problems with my colon.  Furthermore, there is no known family history of colon problems. Dr. Gagliano and Susan Donlon encouraged me to read about my condition, the type of surgery required, and life after surgery. This is when my personal research journey commenced.  My focus from the onset was to embrace this condition.  My quest was to better understand this disease and what impact it will have on my life. Dr. Gagliano recommended, based on the DNA test results, that in the best practice of medicine colon surgery is needed.  I concurred and the surgery, known as a total-proctocolectomy with ileostomy, was scheduled at TAMC.

 The surgery was successfully performed at TAMC in July, 2012.  The rectum, anus, and entire colon were removed. A large mass in the ascending colon turned out to be an 8cm tumor. The pathology report revealed the mass was a tumor and was listed as high grade dysplasia.  As a result of my surgery I have an ostomy which is a prosthetic device that collects my waste. I have adapted to this lifesaving and life changing surgery. To date, I continue reaching out to numerous organizations, both local and abroad, in an effort of sharing my experience. My mindset has been, and continues to be: I tend not to think about things I am unable to control. Medical issues I am unable to control. What I can control is my attitude and after 5 decades on God's green earth my positive attitude has brought me this far, why change now! Furthermore, I can attest that worrying is not the cause of my condition. Therefore, worrying will not make it go away. Based on my personal research of this disease, I am able to better understand my condition, overcome adversity, adapt to my new lifestyle, and persevere with my life. .

 On a personal note, I consider having AFAP as a challenge rather than an obstacle.  I continue to press on with my life with business as usual approach.  As a result I have adopted four (4) words to reflect on as part of my new journey in life as an ostomate and advocate for colorectal cancer awareness focusing on the importance of early detection:

• Attitude = 100% (The English language contains 26 letters. If the letter "A" represents 1 and the letter "Z" represents 26 take the letters of ATTITUDE and add them up. ATTITUDE = 100) It is important to note that the word ATTITUDE is the only word in the English dictionary that equals 100.

  Having a positive attitude attributed to my successful recovery.  As a result my transition to this new style as an ostomate was with minimal difficulty. Furthermore, I believe attitude is permanent and mood is temporary. It is possible to have a positive attitude and be in a bad mood.  However, by maintaining a positive attitude it will have a direct impact on your mood and the outcome of your life. Do not let a bad mood affect your attitude.  I remind myself of this daily and try to remain positive while pressing on with my life.  

• Faith:  Firm Assurance Influenced Through Hope (An acronym I created on my observation of the word faith)

  My analogy of the word FAITH:  Having the ability of believing in something you are unable to see, but you know it is there. Example: You cannot see the prevailing trade winds; however, you can see what affect they have by the swaying of the palm trees.  My positive attitude had a direct impact on my FAITH which allowed me to have a significantly better chance of overcoming adversity.

• Adapt:  Attitude Determines the Ability for a Positive Transition (An acronym I created on life as an ostomate)

  My analogy of the word ADAPT:  After undergoing total-proctocolectomy with ileostomy surgery I had to adjust to this new lifestyle without a colon.  An ileostomy can be best described as a stoma.  This is a surgical opening constructed by bringing the end of the small intestine out onto the surface of the skin on the lower right abdominal area.  The intestinal waste passes through the ileostomy and is collected in a prosthetic pouching system which is adhered to the skin over the stoma.  The pouching system requires changing every 3 – 4 days.  Having an ileostomy is a transition to a life changing experience. 

  It is evident my positive attitude directly influenced my faith which directly aided with my ability to adapt to lifestyle as an ostomate. From the onset I embraced being an ostomate as a challenge rather than an obstacle or disappointment.





 Honolulu Managing Director Ceremony Proclaiming
March 2015 as Colorectal Cancer Awareness Month

• Passion:  My positive attitude along with my strong faith directly impacted my ability to adapt to this new lifestyle with an ileostomy.  As a result I have a yearning to share my story, the importance of colorectal cancer awareness, early detection and AFAP.  This in hopes it will be a source of encouragement and inspiration for the masses. Additionally, on behalf of the Fight Colorectal Cancer and Colon Cancer Alliance I have been asked to represent both organizations in Hawaii and request Hawaii Governor David Ige and Honolulu Mayor Kirk Caldwell to proclaim March 2015 National Colorectal Cancer Awareness month in Hawaii and Honolulu respectively.  



Governor Ige Proclamation of March 2015 as
 Colorectal Cancer Awareness Month

Proclamation ceremonies were conducted in the Mayor’s conference room (above), Wednesday, February 25 and in the State Capital Ceremonial Room (right), Friday, March 13, 2015. It should be noted, these are the first ceremonies of their kind for this campaign.

Together we can make a difference on sharing the importance colorectal cancer awareness and early detection.

Daniel Shockley was diagnosed with Attenuated Familial Adenomatous Polyposis (AFAP), a subtype of Familial Adenomatous Polyposis. Since diagnosis, surgery to remove a pre-cancerous tumor and create an ileostomy, Daniel has made it his mission to spread awareness about colorectal cancer and the importance of early detection. In addition to public speaking, Daniel also uses his experiences to advocate for legislation in support of colorectal cancer detection and treatment programs. All of Daniel's efforts can be followed through The FAP Gene Support Organization, based in England. 

Learn the differences between FAP and AFAP.

One Real Wish and One True Fear: In Support of Cancer Prevention Pharmaceutical’s FAP Clinical Trial

This is a guest post by Travis Bray, Hereditary Colon Cancer Foundation.

Growing up with Familial Adenomatous Polyposis (FAP), for me, meant growing up with an intimate knowledge of my own mortality. I never met my paternal grandfather who died at the age of 36, but the legacy of his death was significant. My father grew up thinking he, too, wouldn’t make it past 36 and lived his life accordingly. As such, he, perhaps unwittingly, passed this notion on to me. At 37, I joke that I’m living in ‘extra innings.’ To quote Skip Carey, the beloved announcer for the Atlanta Braves, it’s ‘free baseball’ from here on out.

Travis successfully tackling the terrain at the Canyons

I live my life with one guiding thought…Every day, I wake up and think “Am I enjoying life?” If the answer is no for too many consecutive days, I begin to make changes. Living with a truncated lifespan, or at least the perception thereof, forces me to live in the moment. I don’t have a savings account because the thought of ‘living until retirement’ is foreign to me. Instead, I capitalize on everyday. I appreciate what I have and continuously strive for what I consider the ideal life. It was easy for me to turn my back on my PhD in Chemistry, leave research, and start the Hereditary Colon Cancer Foundation. I scoff at the conventional 60 hour work week and am fine making less money if it means I can enjoy every day more by doing so. 

I should mention here that the perception of a truncated lifespan is a reality I created. The truth is that, with proper screening and treatment, any person with FAP can live well into their 70’s and 80’s. I would have never believed that had Dr. Randall Burt himself not told me so last year! When he did, I went from thinking I’d die in my 50’s to realizing I can die an old man! Dr. Burt gave me in an instant what no other doctor has…20 extra years!  

To further illustrate my approach to life, I learned to snowboard when I was 36 and became an instructor at 37. As I write this, I am working remotely in Costa Rica while learning to surf in the mornings. My wife, Shawnie, and I live an active life with no intention of slowing down anytime soon. As much as I appreciate life and focus on building a life I can enjoy continuously, not just on the weekends, I have one real wish and one true fear. 

Travis working at a local coffee shop in Costa Rica

My one real wish is that I could have had my colectomy at a later age. I was 15 years old when my colon was removed and, as a result, I have a j-pouch that fits in the cavity of a 15 year old boy. Had I been able to wait 5-10 years, my body would have grown and matured more and my j-pouch could have been bigger. Anyone with a j-pouch knows what the effects would be but, in short, it would be really, really nice if I could reduce the number of bowel movements I have daily and extend the time between to, say, 8 hours. 

My deepest fear is that I’ll one day need a whipple procedure. My father, uncle, and cousin all had this horrible surgery and it grossly decreased their quality of life. I link my father’s early death (age 54) directly to the effects of this surgery. My uncle was extremely ill for a year because of a nicked pancreas during the procedure. Its invasive, life altering, and scares the hell out of me.

This wish and this fear are exactly why I, as an FAP patient and Founder/President of the Hereditary Colon Cancer Foundation, wholeheartedly support clinical trials that test therapies which may prevent the effects of this disease. As of today there are several trials seeking to reduce or eliminate the growth of polyps. You can learn more about these by doing a search on ClinicalTrials.gov. If any of these prove to be successful, children might be able to wait until adulthood before getting a colectomy. 

The trial I want to highlight today is Cancer Prevention Pharmaceutical’s ongoing Elflornithine (CPP-1X)/Sulindac clinical trial. CPP-1X is an experimental drug that is showing evidence to reduce polyp growth and Sulindac is a drug similar to common NSAIDS that has also shown evidence to reduce polyp growth but has yet to be approved by the FDA for this use. Why? Because I’ve spoken at length with the founders and I believe in their mission. They used to work on the other side of pharmaceuticals - working on the treatment of cancer. But they came together to form this company for one reason - to PREVENT, rather than TREAT, cancer in people with FAP. As you can imagine, when I heard their story, I felt relieved that someone out there was fighting for us.

Today, this trial is taking place at eight US/Canadian sites and four European sites. Their drug pairing aims to prevent polyps from growing in the colon. Will they alleviate the need of a colectomy for FAP patients completely? That is to be seen. But the 15 year old kid in me would love to see this treatment help other FAP patients wait until young adulthood to need a colectomy. 

CPP makes no statement as to the efficacy of preventing polyps in the small bowel. But the pathway to polyp formation is very similar in the upper and lower intestines and, for this reason, I’m hopeful that the treatment will also be effective for polyps in the small intestine. 

This clinical trial may be the very answer to my one real wish and one true fear. But to know for sure, the trial needs participants. If you are interested in reading more about this trial, click here. If you do participate, we’d love to hear about your experience.

 Email me at TravisHBray@HCCTakesGuts.org or call me at 334.740.8657.

Before I sign off, I want to offer my deepest gratitude to Jenny Jones Bay and “Life’s a Polyp” for giving me the opportunity to guest blog about this trial.

Take care and stay strong! 

Travis Bray
Founder, President, and Previvor
Hereditary Colon Cancer Foundation

Travis Bray was diagnosed with Familial Adenomatous Polyposis (FAP) at age 15 when he underwent a total colectomy with j-pouch. Like most of us with FAP, Travis has had his own trying journey and obstacles that often accompanies FAP. Utilizing his own experiences and skills, in 2012 he founded the Hereditary Colon Cancer Foundation with his wife, Shawnie, to help fill the many missing gaps in care, support, research, and education surrounding FAP.

Shawnie and Travis Bray