From chaos to order

Oncology nurse navigates her breast cancer journey
Oct. 14, 2015
UCHealth Memorial Hospital Nurse Cindy Dalton discovers a lump in her armpit while showing a patient how to do a self-examination.

The radiation oncology nurse was doing her job, showing a patient how to liberally apply a lotion used to lessen itching and redness.

Using herself as a model, she raised her left arm to demonstrate where the lotion should go. During the demonstration, Cindy Dalton found a large lump in her armpit. Somehow, she kept her uneasiness hidden from the patient.

“I tried to maintain my composure. I finished teaching my patient, and I got on with my day,’’ said Dalton, a nurse for 20 years.

After work that day, the nurse who helps breast cancer patients through their journey went home and checked again, becoming overwhelmed by one thought: This is not normal. As she looked around her home, she felt chaos. On the day she found the lump in her armpit, she was in the middle of a massive kitchen remodel.

A microwave sat on the counter in her bathroom. Pots and pans lay piled up in the bedroom closet. Old kitchen cabinets took up space in the garage. The disarray in her home reflected her thoughts: They were scattered everywhere.

Every day at Memorial Hospital, Dalton is a rock. Patients say she’s gentle, understanding and reassuring. For many years, she has tried to put herself in her patients’ shoes. Now, she is there – the newest member of what’s called the Vulnerability Club, where the company you keep is a voice in your head that won’t stop talking about the “What ifs?’’

“At first, I felt guilty. I’ve been a nurse navigator, ‘How could I miss this?’ ‘’ Dalton sent a text the next morning to Memorial Breast Surgeon Dr. Laura Pomerenke:  “What does your schedule look like today? I found a large lump … ” With that, Dalton began her own breast-cancer journey.

She went to see Pomerenke in the Mary Lou Beshears Breast Care Center. Pomerenke is part of the Breast Surgery Practice that consistently earns outstanding patient-satisfaction scores. In July, 99 percent of patients surveyed said they’d recommend the practice to others.

Dr.  Pomerenke did a breast exam, ultrasound and biopsied the lump. When the results came back, Pomerenke told Dalton she had invasive carcinoma of the breast and it was positive for a protein called Her2/neu, an aggressive form of breast cancer.

Fortunately, a drug called Herceptin was developed and approved in 1999 to help treat this form of breast cancer.

Earlier in her career, Dalton worked as a research RN with a clinical trial that tested the drug. It was a trial that is not unlike hundreds of clinical trials open at UCHealth.  Within two weeks of diagnosis, Dalton started chemotherapy.

Dr. Vishal Rana, her medical oncologist, helped her through the process.  She had six cycles of treatment every three weeks, which lasted for about four months. Three weeks after chemotherapy was finished, Dalton headed to surgery for the removal of 27 lymph nodes, 12 of which were positive for cancer.

Within 6 days after surgery, Dalton was back at work tending to patients who also are on a cancer journey. “When I am with patients, it is about them,’’ she said. “My patients have been my inspiration. I know they have been able to do it – and so can I.”

As a nurse, she grew to understand that everyone deals with breast cancer their own way. Many take it step-by-step, day-by –day. Others may need more emotional or financial support. This is when having a multi-disciplinary team with social workers and a nurse navigator is key to the patient experience.

“Having family, friends and co-workers I could count on for additional support has made a world of difference for me. We tell our patients, ‘We are here for you and we will get you through this.’ What we don’t see is how tough it is for them at home, especially if they live alone.’’

An independent woman who raised two daughters as a single parent, Dalton has relied on few people over her years. Now, the nurse sees what isn’t always apparent in the clinic. “I can’t pick up a heavy pot of water and take it over to the stove. I couldn’t pick up a case of water to place on the bottom of the grocery cart,’’ she said.

Her daughters and family have been wonderful support, though, helping her in countless ways. “Everyone is here for you and wanting to help in any way they can,’’ she said.  “I did reach out, and she came over and I just rested. I think it was good for my daughter and me.

We enjoyed being together, and she just lowered that level of anxiety that I had – the fear,’’ Dalton said. Her co-workers at Memorial have donated Compassionate Paid Time Off, giving their vacation time to Dalton, so that when she needed time off during treatment, she had it.

During October – Breast Cancer Awareness Month – Dalton will have a series of radiation treatments followed by five years of endocrine therapy.

Though her journey continues, Dalton admits there have been a few surprises along the way. Like the day her doorbell rang, and she opened the door of her home to find four Memorial physicians – Drs. Jane Ridings, Stephen Thatcher, Michelle DeWing and Pomerenke – standing on her porch with many other co-workers from Memorial. By that time, new cabinets had been installed in her kitchen.

The team was there with covered dishes, good wishes and specific intentions. They got to work quickly and moved the microwave oven out of the bathroom, the pots and pans out of the bedroom, and placed the silverware in drawers, putting some order back in Dalton’s world.

About the author

Erin Emery is editor of UCHealth Today, a hub for medical news, inspiring patient stories and tips for healthy living. Erin spent years as a reporter for The Denver Post, Colorado Springs Gazette and Colorado Springs Sun. She was part of a team of Denver Post reporters who won the 2000 Pulitzer Prize for breaking news reporting.

Erin joined UCHealth in 2008, and she is awed by the strength of patients and their stories.