Family House Diaries: Being a Good Patient, Becoming a Better Nurse

Treatment for a benign tumor at the base of her skull helps a Sampson County native and Veteran’s Administration hospital nurse get everything else right in her head and be on alert for the unexpected blessings of life.

Family House Diaries:  Being a Good Patient, Becoming a Better Nurse click to enlarge Geneane Marshall

Media contact: Tom Hughes, (919) 966-6047, tahughes@unch.unc.edu

Wednesday, Sept. 21, 2011

Written by Elizabeth Swaringen for UNC Health Care

CHAPEL HILL, N.C. – Geneane Marshall believes being treated for a tumor at the base of her skull helped her get everything else right in her head.

“Whether your prognosis is good or bad, it takes you out of your element,” said Marshall, 51, of Roseboro in Sampson County, N.C.  “You can’t change the diagnosis.  It is what it is, but there are unexpected blessings along the way that reinforce you are where you are supposed to be, doing what you are supposed to be doing.  I know I am blessed.”

Marshall, a nurse at the Veterans Administration Hospital in Fayetteville, received five and a half weeks of radiation at UNC Hospitals to treat a skull-base glomus tumor.  The tumor was discovered five years ago, but it had not grown until early 2011.

“These kinds of tumors tend to be slow growing and benign, but when they progress they can cause problems for the cranial nerves that control swallowing, speech, chewing, hearing and even breathing,” said David E. Morris, MD, associate professor of radiation oncology at UNC Lineberger Comprehensive Cancer Center, and member of the multidisciplinary team directing Marshall’s care.  The team also included a head and neck surgeon and a neurosurgeon, who determined that surgery could have yielded more damage than benefit.

“Historically, these types of tumors were treated with surgery, but we’ve learned that radiation is a particularly exciting option for controlling tumor growth when all the cranial nerves are working as they should,” said Dr. Craig A. Buchman, professor of otolaryngology/head and neck surgery, adding that UNC Hospitals treats 10 to 15 patients a year with this type of tumor.  “Ms. Marshall was a particularly good candidate for radiation and that we could work as a multidisciplinary team was to her benefit.”

“Usually these tumors do extraordinarily well with radiation, with an over 90 percent local control rate,” Dr. Morris said. “We offered treatment that we believed would leave fewer side effects than those that would result from lack of treatment.  She’s done extremely well, and we believe she has an excellent chance for many decades with good quality of life ahead.”

Thankfully, the nerves that control Marshall’s hearing and speech remained unharmed for Marshall, a soft-spoken, careful listener yet highly opinionated woman who doesn’t shy away from saying exactly what she thinks.

Every Monday from Easter through early June, Marshall drove herself to UNC Hospitals for five days of radiation and stayed the week at SECU Family House, a 40-bedroom hospital hospitality house minutes from UNC Hospitals.  Family House provides comfortable, convenient and affordable housing for seriously ill adult patients and their family member caregivers.

“If I could measure my endorphins when I pulled into the SECU Family House driveway, they would be off the charts,” Marshall said. “The experiences I had there have saved my life.”

Marshall learned to make healthy eggplant parmesan from a fellow Family House resident.  “I heard a man play cello, and he laughed like Santa Claus,” Marshall said, recalling one night’s after-dinner entertainment.  “And I learned to sit on the porch and hear absolutely nothing.”

On Tuesdays, after radiation, Marshall made it back to Family House in time to fold laundry with volunteers. “That was my therapy,” she said.  “It took the place of shopping which was an emotional addiction I’d had for years.  It’s amazing how much freer and freeing I feel.”

Family House also allowed Marshall to reconnect with a fellow high school classmate she had not seen since graduation who was at Family House with her husband who was being treated with surgery and radiation at UNC Hospitals.

“It was great to see her and wonderful to connect with him,” Marshall said, beaming.  “We shared helpful hints we’d learned on our journeys here, namely: ‘no whining allowed’ and ‘eat even if treatment alters the taste of food’.  We talked about how glad we were to be alive, and we prayed together for our children and grandchildren.”
Marshall also found support from fellow patients she met at radiation.

“One told me how a little cinnamon candy helps if your mouth and stomach aren’t feeling quite right,” Marshall said.  “Another fellow patient referred me to the recliners in the Patient and Family Resource Center (off the lobby of the N.C. Cancer Hospital).  I was able to go there when I needed to forget about what I was going through, have a cup of tea and just sit and relax.  It felt just like home.”

Marshall believes being a patient will make her a better nurse.

“I’ve learned to really listen to what’s being said and for what’s not being said,” Marshall said.  “You wouldn’t believe the stories people have, and everybody has at least one.  If you listen–really listen–you will learn what’s going on and what the issues really are.  You don’t know what people are carrying just by looking at them.”

Marshall is convinced her own medical journey had nothing to do with the tumor in her head and everything to do with a second chance to pay attention to what’s really important.

“We all have what’s important and dear to us, but too often in the busyness of life we get distracted,” Marshall said.  “You know that in your own head, but I didn’t get it when the tumor was first found.  If I hadn’t gone through this, I wouldn’t have taken time to sit on the porch.”

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