The pain after

Every time Bob Palmer visited his daughter, Michelle, while she received cancer treatment in Seattle, he wondered if it would be the last time he saw her alive.

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But the waves of panic didn't strike him until two years after Michelle received a bone marrow transplant.

"We were pretty much on the edge for a long time," said Palmer, who had to see a counselor to deal with the anxiety. "After the transplant, she was on a lot of anti-rejection medication. When we started relaxing a little bit, she got sick again and we had to take her back to the hospital. I got a little bit panicky when we had to do that."

Palmer's stress is shared by many parents whose children have survived cancer.

Research has shown that although children with cancer generally do well psychologically once their treatment is finished, their parents often don't.

"Depending on the age of the child, parents may have a greater appreciation of the situation," said Robert Butler, a pediatric oncology researcher at the Oregon Health Sciences University. "While the children may worry about losing their hair and having to go back to school, the parents are worried that their children might die."

Palmer's wife, Glenda, has her own theory.

"As parents, your job is to protect your child. When you get into a position of not being able to protect your child, it affects you emotionally," said Glenda, 49.

Butler, who has worked for 15 years with families who have children with cancer, said traumatic experiences leave mental scars in the same way a physical injury marks the body.

"Witnessing the near-death of a family member is considered the same class of all the other awful things that can cause post-traumatic stress disorder, such as combat, rape or being held hostage," Butler said. "When something awful happens to us, we have a greater appreciation of life afterwards but we might also be traumatized. It is the price we pay for being human."

In some serious cases, the stress can harm marriages, lead to substance abuse and cause people to alienate themselves from their friends.

"Post-traumatic stress disorder is usually associated with more severe traumas, such as long bone marrow transplant hospitalization, serious infections and dire complications that cause pediatric intensive care unit admissions," Butler said.

Glenda Palmer said she suffered from guilt when Michelle stayed at the bone marrow transplant unit.

"You thanked God that your child was surviving, but you felt guilty seeing other people's children die," she said.

Some of the symptoms of post-traumatic stress include recurring recollections of the trauma, inability to recall important aspects of the situation or difficulty sleeping.

"The symptoms can bounce back and forth. Sometimes patients are not able to remember details of the event and then all of a sudden they are washed by the memories," Butler said.

Bob Palmer said his stress resulted from the family's separation.

During the eight months Michelle was in Seattle receiving treatment, Palmer had to stay in Juneau, working and taking care of his two elder sons.

"The problem of being away was that you were not in the middle of it and that you were not as well-informed," Palmer said. "Sometimes you couldn't sleep the whole night and started thinking about the worst."

Palmer, who visited his daughter and wife every six weeks, sometimes had to leave when Michelle teetered close to death.

"You had to make decisions very quickly. Do you stay or do you go home?" Palmer said. "Seattle is thousands of miles away from Juneau. You cannot just hop into your car and go down there."

Palmer recalled one of the scariest events during Michelle's treatment.

"One day, a nurse gave Michelle some vitamin K for an exam. She warned me that Michelle might go into shock but that didn't happen often. But the minute the nurse walked out of the room, Michelle went into shock. I flew down the hall to catch a nurse. Then doctors and nurses rushed back to the room," Palmer said. "There were too many bad surprises. It wore you out."

Rob Corcoran, 37, joked that he and Palmer belonged to the "left-behind club." Corcoran was separated from his wife, Lisa, for 10 months when she stayed in Seattle to take care of their youngest son, Connor. Connor, now 4, was diagnosed with neuroblastoma, a complex tumor of the sympathetic nervous system, when he was 2 months old.

"We took the support role instead of fighting on the front line," Corcoran said. "Sometimes it can be harder because you felt kind of out of the loop. Although I got to go to Seattle pretty frequently, Connor didn't know who I was. Having a son who didn't know who you are is the hardest."

Butler said talking about the stress is the best way to deal with it.

"Having a group of parents who have children surviving cancer share their experience is very effective," Butler said. "People who are afraid of hospitals can spend their afternoons sitting in the hospital until the response to fears goes away."

Glenda Palmer dealt with the stress from Michelle's annual checkups in Seattle by incorporating fun in their trips.

"Every time you went back and saw those light-bulb heads, you kind of relived the whole thing," Glenda Palmer said. "Michelle and I went shopping or visiting friends after the checkups."

Michelle, now 20, is a freshman at University of Alaska Southeast. She has been cancer-free for seven years.

Palmer said the experience taught him to appreciate life more.

"Life is valuable," Palmer said. "I am very thankful that Michelle survived. Not everyone does."

• I-Chun Che can be reached at ichun.che@juneauempire.com.