Troylene Merrill: The Importance of Caregiving

A Bessemer City, N.C. woman is referred to UNC Hospitals for treatment of a recurrence of breast cancer and brings with her a posse of support and encouragement for the journey.

Troylene Merrill:  The Importance of Caregiving
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Over six weeks this May and June, Troy received non-smothering caregiving by a posse of dear friends who — one-by-one — accompanied her to the North Carolina Cancer Hospital.

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

Wednesday, July 18, 2012

Written by Elizabeth Swaringen for UNC Health Care

Chapel Hill, N.C. – Troylene Merrill knows about caregiving — as a giver and as a receiver.

“Caregiving is hard work, but it’s work you never regret,” said Troy, 66, of Bessemer City in Gaston County, who was full-time caregiver for her seriously ill husband, Bill, the last three years of his life.   

“You do what you need to do, and no two caregiving experiences are alike.  It’s important to be encouraging, but not to smother someone by hovering 24/7.  You have to give the patient space.”

Over six weeks this May and June, Troy received non-smothering caregiving by a posse of dear friends who — one-by-one — accompanied her to the North Carolina Cancer Hospital where she received oral chemotherapy and twice daily doses of radiation for a recurrence of breast cancer.

“I have always been a strong-willed, hard-headed, take-charge kind of person,” said Troy, a retired textile machinery parts and service manager.  “I was going to be brave, put on my big-girl panties and come by myself.”

But the posse had other plans.

“I didn’t ask for it, but I was presented with a plan they had worked out of who would be coming with me each week,” Troy said. “They presented it as a comfort and a help and a second set of ears for all the appointments. I knew they were right.”

The posse, which started with six friends who gathered on Fridays for lunch and afternoon-long card games, expanded to include other friends and family members during the weeks of Troy’s treatment.  All have some degree of caregiving experience and many have lost the loves of their lives despite their best efforts.

“We have shared experience, and it’s unspoken how we care for each other,” Troy said. “We are very good friends under all circumstances.”

Armed with notepads and extra doses of good humor, posse members took turns leaving Bessemer City on Sunday afternoons with Troy for the nearly four-hour drive to Chapel Hill.  The duos returned home on Friday, and the same process, different sidekick, repeated on Sunday.  

While in Chapel Hill, Troy and her caregiver-of-the-week stayed at SECU Family House, the 40-bedroom hospital hospitality house minutes away from UNC Hospitals that provides comfortable, convenient and affordable housing for seriously ill adult patients and their family member caregivers.

“We learned about Family House on my first trip for the consultation,” said Troy.  “I fell in love with it.  You are made to feel like a special person here, not a patient.  You look around and there’s someone dealing with something worse.  My heart goes out to them.”

Troy was referred to UNC by her long-time oncologist Viputal Patel, MD, of Gaston Hematology & Oncology.  

“I was torn about being away from home and leaving his excellent care, but we both knew I needed to be referred,” Troy said. “I asked where he would send me if I were his wife or mother.  He said ‘UNC’.  I asked if he loved his wife and mother, and he said ‘very much so’. That’s why I’m here.”  

Troy is no stranger to cancer and its treatment.  

“When I was 26, I had cervical cancer.  In my mid-30s I was diagnosed with a rare type of gynecological cancer normally associated with women in their 60s or 70s.  In my 40s, I had breast cancer.  Cancer skipped my 50s, but then in 2010 I had breast cancer, subsequent surgery and chemotherapy.  It was in remission until it popped up again in January as metastasis in my lymph nodes.

“However you count it I’ve been treated for cancer four or five times. To me, cancer really is a four-letter word:  F-E-A-R.  Fear of the unknown. Fear of the illness.  Fear of dying. That’s cancer.

“But my hope and strength come from God, and I know if it’s His will, I will live,” Troy said.  “If not, there’s nothing anyone — me, the posse, my doctors — can do about it. We can’t change the diagnosis, and if we can’t change it, we can’t worry about it.”

At UNC Troy has been under the care of Hyman B. Muss, MD, professor of medicine and director of geriatric oncology, and Timothy Zagar, MD, assistant professor of radiation oncology, both members of UNC Lineberger Comprehensive Cancer Center.

“Fortunately, those early cancers were a long time ago and are not likely to come back,” said Dr. Muss. “Our concern is getting the recurrence of breast cancer under control and stopping subsequent spread. She’s certainly gone through more than most patients, and she’s tolerating her treatment well.”

The twice-daily radiation treatments were based on good scientific evidence that shows lower doses of radiation given more frequently likely means fewer side effects,” said Dr. Zagar.

“It’s a common misconception that once you’ve had radiation, you can’t have it again,” Dr. Zagar said.  “Frequently that’s true, but not always. Troy was the perfect patient for that regimen.”

As she neared the end of treatment, Troy’s skin was tender and painful, and she broke down in tears.

“I reassured her she was allowed to do that,” Dr. Zagar said. “She’s been through a lot, and many out there – including me – are not as strong as her.  I adore her and admire her.

“And we can’t put into words the value of that great support network.  A friend — obviously a dear friend — was always with her, taking notes, asking questions, just being with her so she wasn’t alone.”

Troy finished radiation on June 26, getting home in time to rejoin the posse’s Friday activities.  She’s giving input to committee planning the Oct. 6 reunion of anyone who graduated from Chesterfield (S.C.) High School prior to 1969. And she joins family and friends in celebrating the arrival of her first great-grandchild, Mason Tyler Merrill, born July 9.  

A few beach trips are in the offing “when I get back strength and am ready to go again.”  And the already-planned New England cruise is now a celebration trip come September.

“Bill and I always had the dream that when we retired we’d travel,” Troy said.  “His health didn’t allow that. I’m trying to travel enough for the both of us. I think I’m doing a pretty good job of it.”

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