How To Help Ensure You Die On Your Own Terms

From LA Times
By Lisa Zamosky
September 21, 2014

Earlier this year, Gary Spivack and his sister Betsy Goodkin lost their mother to cancer. Between her first diagnosis and her death in April, her children say, their mother was determined to overcome her illness..

"She was a very stubborn and proud person who fought this and had a lot of support from immediate family and a lot of friends," says Spivack, 49, a music industry executive who lives in Pacific Palisades.

"She was going to live out her final minutes as healthy and fighting it as much as she could," adds Goodkin, 51, who describes herself as a "full-time mom" in the Cheviot Hills neighborhood of Los Angeles.

But even as their mother fought to stay alive and healthy, her children say, she made her end-of-life wishes known: If death was imminent, she wanted no heroic measures taken to save her life. And she insisted on dying at home.

They said their mother passed away April 13 in just the manner she had hoped: She was in her own bedroom with the lights low and the mood peaceful. She held hands with loved ones as she passed.

Dr. Neil Wenger, director of the UCLA Health Ethics Center, said most patients would prefer to die that way, but few actually do. That's because they fail to put their final request in writing, he says.

Without advanced planning, he says, most people die in hospital intensive care units, "in not the most dignified circumstances, in a way most say they don't want to die."

Why the gap between what people say they want at the end of their lives and what actually happens? There are many reasons.

A recent study published in the American Journal of Preventive Medicine found that lack of awareness is the most common reason people cite for not having written instructions prepared in advance.

Denial is at play too.

"People go into a mode of thinking — and are encouraged to — that 'if I just apply enough technology I will survive it,'" says Barbara Coombs Lee, president of Denver group Compassion & Choices. They even continue "in that mode of thinking when it's perfectly obvious they are actively dying."

Doctors also avoid such talks. Some physicians incorrectly believe patients don't want to discuss death. Others pass the buck, believing it's some other doctor's responsibility to have the discussion.

These talks take time and can be emotional. "Doctors are human and they bring to the table a lot of their own emotions about death and dying, and these can be very difficult conversations to have," said Dr. Glenn Braunstein, vice president of clinical innovation at Cedars-Sinai Medical Center.


A report out last week by the Institute of Medicine stated that medical and nursing education fails to orient healthcare providers toward less aggressive forms of end-of-life care, and many providers simply lack the communication skills needed to have these conversations.

Also, the report noted, providers are still largely paid to deliver more services, rather than fewer — even when treatment is futile.

Experts offer recommendations for putting end-of-life plans in place and what needs to be considered.

Open up the lines of communication. Frequent conversations about end-of-life goals between doctors and patients are essential if unwanted treatment is to be avoided, experts say.

"When people fail to plan for the worst, often they find themselves in a struggle to avoid an imminent and inevitable death that ends up causing an enormous amount of suffering for them and for their family members," Coombs Lee says.

"Anyone with a life-threatening disease should know their options and the efficacy rate of any treatment they are offered," she says.

Insist on shared decision-making. End-of-life conversations should be part of shared decision-making between a patient and his or her doctor, Braunstein says.

"You take into account the patient's preferences, their spirituality and a variety of things. At the same time the physician should be giving honest information about what the prognosis is, what we can do and what we can't do," he says.

Talk about comfort care: Conversations should include discussions about your various treatment options, including palliative care, which emphasizes a patient's physical and emotional comfort. Braunstein said palliative care should start well before a patient is terminally ill.

Also important is to talk about hospice care — treatment when you are no longer attempting to prolong your life but rather focusing on staying comfortable and managing pain in your final days.

"We think of hospice care delivered in the home as the gold standard," Coombs Lee says.

Research suggests that people who receive palliative and hospice care may live longer than ill patients who don't.

Select an agent. It's a good idea to name someone such as a family member or close friend to serve as your healthcare agent.

This should be the person you most trust to represent your best interests and who will make sure your wishes are respected and carried out. Your agent can't be your doctor or other healthcare providers treating you.

Establish an advance care directive. These directives for your last days are legal documents. They allow patients to state their treatment wishes and appoint someone to make medical decisions on their behalf.

They should spell out what you want to have happen and what you don't. They must be signed by two witnesses — not your doctor or the person you name as your healthcare agent. Alternatively, you can have the document notarized.

A copy should be given to your healthcare agent, other family members or friends, and to your doctor. Ask that it be included as part of your medical record.

Get your doctor's orders in writing. A Physician Orders for Life-Sustaining Treatment is a frequently used document to be signed by both the physician and the patient.

It generally is filled out when a person's anticipated life span is six months or less and is put in a prominent place where caregivers and paramedics can see it. "The document is pink so it stands out, and we tell people to put it on their refrigerator or where they're sitting downstairs," Braunstein says.

Goodkin of Cheviot Hills says she learned a lot from her mother's passing in April, namely about how to die on your own terms.

"Everybody wants to die with dignity, bottom line," she says. "Whatever that means to somebody, you just have to honor that."

healthcare@latimes.com

Zamosky is the author of "Healthcare, Insurance, and You: The Savvy Consumer's Guide."

Read the original article here.

RECIPE: Stuffed French Toast by Pam Braun

Recipe from Pam Braun, Author of The Ultimate Anti-Cancer Cookbook. Pam will be speaking at our Shining a Light on MPNs: Myeloproliferative Neoplams educational awareness event on Sept 20, 11am-3pm. Visit this website to learn more.

Stuffed French Toast

Impress yourself and your friends by serving this easy, decadent, yet healthy breakfast.  Stuffed French toast is generally loaded with unhealthy fats and calories. This recipe, though, is made with fresh fruit, almond butter, whole grain bread, and toasted walnuts for a warm, gooey morning treat. 

Berries pack a solid antioxidant punch.  The small, yet mighty berry may well protect you from heart disease, cancer, Alzheimer’s, Parkinson’s, macular degeneration, and more. 

Ridiculously easy to make, beautiful on the plate, and healthy yet scrumptious to eat, your guests will definitely be asking for this recipe on their way out your door.

4 pieces whole grain or whole wheat bread
4 tablespoons almond butter
2 bananas, sliced thinly long-ways
4 large strawberries, sliced thinly
½ cup fresh blueberries
2 eggs
1 cup nonfat or soy milk
1 teaspoon cinnamon
½ teaspoon salt
½ teaspoon almond extract
Zest of 1 large orange
Zest of 1 large lemon
¼ cup chopped walnuts, toasted
Dusting of powdered sugar (optional)
Canola oil spray

Spread almond butter evenly over 4 pieces of bread, as this will help hold the French
toast together. Place the sliced bananas evenly on top of almond butter on 2 pieces of
bread. Place sliced strawberries evenly on top of banana slices and blueberries evenly
on top of strawberries.



Make 2 sandwiches by placing the almond butter covered pieces of bread on top of
the fruit layered pieces of bread. Press the sandwiches down lightly so that they hold
together when dipped into the egg mixture. Cut sandwich into quarters diagonally.


In a medium bowl, mix the egg, milk, cinnamon, salt, and almond extract, and whisk
together well. Dip the sandwich quarters into the egg mixture to coat thoroughly.
Preheat a griddle or skillet to medium. When you are ready to place the French toast
on the griddle or skillet, spray the preheated griddle or skillet with canola oil spray.


Place the dipped sandwich quarters onto griddle or skillet and cook for 3 minutes on
each side, flipping the sandwiches until both sides have a golden brown color.
When finished cooking, dust with zests and toasted walnuts. Dust with a very light
dusting of powdered sugar, if desired.



Serves 2-3.

'It's time for circle singing! Join us this Saturday, September 6 at the Cancer Support Community!

"... If you can walk you can dance. If you can talk, you can sing ..."

Join us this Saturday, September 6 at the Cancer Support Community for a joyful hour of Saturday Circle Singing! 

Group singing his measurable health benefits. Read this article and then experience it for yourself by joining the circle. We hope to see you there! Bring a friend or just come by yourself. Either way, our circle requires no prior experience or note reading. Just come ready to enjoy the uplift, fun and community of singing with a group!

Details:

First Saturday Circle Singing

DATE:  Saturday September 6, 2014;

TIME:  10:45 am - 12:00 noon

COST: FREE! and free validated parking

LOCATION: Cancer Support Community - Benjamin Center

1990 South Bundy Drive, Suite 100

Los Angeles, CA 90025

About your Circle Singing instructor and songwriter, Patricia Bahia:

Los Angeles-based singer-songwriter and ovarian cancer survivor Patricia Bahia (pronounced ba-HEE-yah) combines elements of pop, singer-songwriter, with hints of country and soul, to create sparkling gems of piano-based pop songs. She blends catchy melodies with lyrics celebrating life’s struggles and triumphs, and delivers them with a voice as smooth as a polished stone that has been through the rock tumbler of life. Drawing favorable comparisons with Ingrid Michaelson, Aimee Mann, and Sara Bareilles, Patricia creates music that is uniquely soothing, refreshing, memorable, with a sound that is all her own.

A former jazz and gospel singer, Patricia started her career as a soloist with the acclaimed Oakland Interfaith Gospel Choir--recording with Linda Ronstadt, performing with Joan Baez, and opening for Bonnie Raitt. Patricia discovered her “bucket list” desire to write songs during a successful battle with ovarian cancer ten years ago. She credits her illness with the discovery of her songwriting voice, and the power of music with her recovery. Now healed, Patricia is on a mission to spread love, healing, joy and peace through the power of words and music--and to inspire others to follow their dreams and live artistically.

Patricia’s music is available at: iTunes, CD Baby and Amazon.com

Learn more at:www.patriciabahia.com


Note: We need some photos of the circle in action that the CSC can use on fliers and website to let folks know about Circle Singing. We hope to have someone there on Saturday to take a few pictures. If you would like to be in the pictures, you will be asked to sign a photo release. If you don't want to be in the picture, please join us anyway. You will still be able to participate in the circle without being photographed.

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The mission of the Cancer Support Community is to ensure that all people impacted by cancer (including survivors, family and friends, and caregivers) are empowered by knowledge, strengthened by action, and sustained by community.  All programs and services are provided free of charge. Learn more on our website, or stop by the center for a free course. We look forward to meeting you.

Cancer patients with depression 'are being overlooked'

August 27, 2014
BBC NEWS HEALTH
By Smitha Mundasad

Three-quarters of cancer patients who are clinically depressed do not get the psychological therapy they need, according to research in the Lancet.

This "huge unmet need" is partly due to a focus on physical symptoms at the expense of good mental healthcare, researchers say.

They argue depression is often overlooked but could be treated at a fraction of the cost of cancer drugs.

Charities say the current situation is "heartbreaking".

Continue reading the main story “Start QuoteIt is heartbreaking to think cancer patients who are already dealing with the toughest fight of their lives are also struggling with depression, without adequate support”
End Quote Jacqui Graves Macmillan Cancer Support
'Persistent sadness'

People often wrongly assume that major depression is part of a natural reaction to cancer - but this is much more than transient sadness, the Edinburgh and Oxford university researchers say.

Their report suggests a new nurse-led treatment could help thousands of people.

In a series of studies they analysed data on 21,000 cancer patients living in Scotland.

They found 6% to 13% of people had clinical depression, compared with just 2% of the general population at any time.

Jump media playerMedia player helpOut of media player. Press enter to return or tab to continue.Cancer survivor Sonia Wilson said cancer made her feel "like a burden to society"

Sufferers of major depression feel persistently low, may find it difficult to sleep and have poor appetites.

But researchers found 75% of people reporting these symptoms were not receiving treatment, partly because they did not consider seeking help and professionals did not pick up on their illness.

The reports also show that, even when given a diagnosis and standard NHS treatment, the majority did not feel better.

Scientists say a new nurse-led approach designed specifically for patients with cancer can substantially reduce depressive symptoms.

In their study of about 500 patients, the therapy halved the depression scores of more than 60%.

Patients reported they were less anxious, less fatigued and experienced less pain.

Only 17% of those who had standard NHS care had similar results.

picture of man with head in hands Some 13% of people with lung cancer reported symptoms suggestive of major depression
'Profound impact'

In contrast the new intensive, tailored approach is delivered by a trained cancer nurse and involves the wider medical team.

It includes:

antidepressant drugs
encouraging patients to become as active as they can be
problem-solving therapy
Researchers argue that if their programme were rolled out widely it could improve the quality of life for thousands of people.

Their final paper suggests the therapy improves quality of life, regardless of how good a patient's prognosis is.

Dr Stefan Symeonides, of the University of Edinburgh, said: "Day-to-day oncologists like myself see the profound impact depression can have on a patient with cancer."

He added: " [This is] a huge area of unmet need missed by current practice."

Researchers say the therapy costs around £600 per patient.

Jacqui Graves, of the Macmillan Cancer Support charity, said: "It is heart-breaking to think cancer patients who are already dealing with the toughest fight of their lives are also struggling with depression, without adequate support.

"Anyone experiencing depression should get in touch with their GP."

View the original source article here: http://www.bbc.com/news/health-28954661

STAYING FASHIONABLE DESPITE THE ODDS

By Victoria Moore

 

   The other day I was asked by someone in an online discussion, "Which one word do you want people to think of when they think of you?" Without a second thought I said, "Stylish." If you'd have asked me that same question four years ago when I was diagnosed with Stage II A Breast Cancer, I might've said ,"Tough," but now that I'm in my post-cancer treatment phase I feel my journey has been personified by my appearance. Regardless of my financial circumstances, physical state or lifestyle changes I've discovered how to project self-assurance, mastery, courage and substance through the way I've dressed on my journey. Looking back I realize that was one of the ways I maintained my dignity while living with the disease.

   According to writer and breast cancer survivor Madhulika Sikka in her book "A Breast Cancer Alphabet," "Going through something like cancer treatments is hard, and it shows. If it works for you, to don a mask, great, because you and no one but you gets to decide how you look." During my current phase I've been subjected to criticism by people, who've never walked in my shoes, for "dressing" and it's led to unnecessary conflicts and misunderstandings that've added to the stress and anxiety I already feel as I try to rejoin the real world. A few months ago I read an article about an African woman who made peace with herself and her stylish upbringing by embracing it as a professional woman now living in the United States. Before she decided to dress beautifully, she'd downplayed that side of her personality so that she'd be taken seriously in the workplace. The thing I really related to, in the article, was how she came to the realization that being chic was a significant part of who she was and she was cheating herself by submerging it.
    As I struggled with cancer I was confronted by my own inner struggle over whether or not to hang onto this aspect of my life forever. Despite what my naysayers have said I've decided to keep it and enjoy it to the hilt. For women with breast cancer getting dressed and looking stylish can be a daunting challenge since they not only have to deal with the results from a mastectomy, scarring, side effects from chemo, procedures and medication they might also have to deal with isolation, depression and budgetary restrictions.

Ivey Abitz:

   After I had my first chemo treatment my immune system became so compromised that I couldn't go out in public and shop when I needed to. I did have internet access, however, and through my account on Face book I discovered a wonderful clothing company called "Ivey Abitz." Created by Cynthia Ivey Abitz and her husband Joshua Ivey Abitz their philosophy is "to give a nod to the past and present." Vintage-inspired and classic, their women's collections are timeless, versatile, unique and exquisite. For Summer 2014, even though I thought everything was beautiful, the one look that caught my eye was featured in their May 31, 2014 blog "Cottage Design Collection." Described as "having abundant ease and comfort," I felt Look No. 26, a beige cardigan over a white camisole and beige frock was the perfect outfit for someone going through the breast cancer journey because everything can be layered for warmth in case the examination room or the chemo suite is chilly, and the pieces can be easily removed for procedures. Dressy enough to be worn to a job, with a semi-casual atmosphere, it can also be worn to a support group or a local art gallery opening.

Angela Sum:
   While the internet is an excellent place to look for clothing choices, when you can't physically go to the stores, T.V. is another. When I was quarantined at home and in the hospital, I also kept up with fashion by looking at "America's Next Top Model" and "Project Runway." This season, I was immediately struck by how L.A. fashion designer Angela Sum, presented her "practical clothes" to the judges. What set her apart from the other contestants for me was the calm way she talked about "how she wasn't trying to reinvent the wheel but instead wanted to add subtle changes to classics that brought out a woman's femininity but also made her look like an individual."
   Considering the obstacles I've had with dressing in separates that would camouflage my surgical scars, and be versatile enough to accessorize easily, I felt the white "alternative dress shirt" and grey skinny pants Sum wore on one of the episodes would be the perfect solution to this problem. Roomy and loose enough to wear over a white t-shirt or tank top for extra warmth if I got chilly on a doctor's visit, the dress shirt is also elegant enough to wear to work then on a dinner date afterwards.

Looking to the Past for Inspiration:

 

 
    Before I was diagnosed with lupus in 2008, then lost all of my hair to chemo, I'd worn sunglasses and hats every now and then, but when I was forced to deal with these obstacles full time I had to find a way to incorporate them into my look. Physically, I have a tall, slender frame, long neck and small head so I was drawn to cloche hats and knit berets then. I've always been a huge fan of the 1920's so I adopted this style and still wore it once my hair grew back because it was very becoming.
   To keep up with different versions of the trend I look at books like Betty Kreisel Shubert's "Out-of-Style A Modern Perspective Of How, Why and When Vintage Fashions Evolved." Through her illustration in the section "The Changing Shapes of Women's Millinery 1906-1920's" I learned how to alter this look and make it more girly by accenting a hat with a flower pin.
   During those times when I couldn't replenish my wardrobe, through shopping, I often relied on older things I've owned for years to coordinate. When I read Shubert's quote, "Clothes that earn the title "Classic" or "Vintage" are beautiful in their own right," I felt justified for hanging onto them and wearing them when I needed and wanted to.
    Wherever you choose to seek inspiration, and however you try to stay within the fashion loop during your journey with breast cancer, don't forget to see it as part of your recovery and a way to add structure to your life as you travel on this new and interesting path.

Resources:
1) Ivey Abitz (www.iveyabitz.com)
2) Angela Sum (www.angelasum.com)
3) "Out-of-Style A Modern Perspective Of How, Why and When Vintage Fashions Evolved," written and illustrated by Betty Kreisel Shubert (www.outofstylethebook.com, bettyshubert@cox.net). This book is a great read and is a good way to escape and learn more about fashion from an insider.

THANKS FOR THE MAMMARIES!

Check out this blog post from Paula Tiberius.  Paula participated in an art show benefitting CSC entitled Thanks for the Mammaries at ForYourArt Gallery.  Artist and breast cancer survivor Bettina Hubby created this show.  Thank you to Bettina and Klowden Mann!

http://paulatiberius.com/blog/2014/08/01/thanks-for-the-mammaries/

BEYOND BLACK AND WHITE: TRANSLATING A TREND

By Victoria Moore
Victoria writes about all things fashion-related and is a Stage IIA Breast Cancer survivor

 Looking for a job is never easy, especially when you've just spent four years of your life battling Stage II A Breast Cancer and other health issues, but the thing that's made it particularly hard for me is navigating around the challenges of resumes, interviews and employment inquiries in clothes that make me look professional and stylish yet remain comfortable and polished throughout the day.
   To get the crisp, fresh allure I was seeking when I had to go to an interview with a staffing agency last month I selected a trend that's always appealed to me-black and white. Reminiscent of art deco, film noir and the Mod gear from the 1960's, it took me back to the 1980's when I worked as a salesperson at The Limited in the Century City Plaza. While working there we were required to buy and wear their clothes on the sales floor during our shift. I didn't make a lot of money then, but I still needed the job, so I had to find a way to conform and keep my managers happy. I decided to create a formula of black and white separates that I could mix and match easily.

The Formula:
   Small, but versatile, I remember buying a white mini skirt, a black mini skirt, a white shirt, a black shirt and a pair of black slim fitting pants. All of the pieces were made out of cotton so I didn't have to take anything to the dry cleaners or worry about being uncomfortable when I wore them. I wouldn't say this was my finest fashion moment but at least it taught me how to create a uniform from one store's offerings that worked on and off the clock. At the time the only clothing problems I had to worry about was how to find something in my size and something I could afford. When I approached the black and white color scheme this time I had to figure out how to coordinate an outfit that wouldn't show all of my surgical and procedural scars and make me look as in control as possible.

   "People of all ages and circumstances of life are aware of appearance in perception of self and their relations with other people," wrote Abilene M. Hoffman, Ph.D. in Clothing For The Handicapped, the Aged, and Other People With Special Needs. Before, when I chose black and white I wanted to get the approval from my supervisors at The Limited, but this time I wanted to appear competent and prepared for a general office position by an organization that I hadn't worked with in over five years. The ability to project my most positive and best self after my stint with Breast Cancer has been a fraught with frustrating obstacles and disappointing outcomes, as my job search stretches out longer than I anticipated.

Doing My Homework:
   With this in mind I studied my fashion magazines for the season's trends and become inspired by a layout feature called mono pattern in the May 2014 issue of the Japanese version of NYLON. The placement coordinator told me, over the phone, to "dress as if I were going on a job interview" when I asked what I should wear to meet with her. I didn't want to limit myself just in case I changed my mind, so I pulled my black Calvin Klein dress out of my closet, along with my off-white and black striped sweater set by Ann Taylor, my black Ann Taylor Loft pants and my black and white pinstriped blazer by Norma Kamali.

   For a time, right after I started my chemo treatments, my skin turned sallow and I had dark bags under my eyes that were more prominent when I wore black near my face so I stopped wearing it and chose brighter colors and prints instead. I've since made my peace with black because it doesn't make me look sick any longer, and I've finished chemo, so I've learned how to coordinate around it without losing my individuality. Besides I've also had to compromise and accept the corporate policy some retail stores adhere to when I've interviewed with them and contemplated being employed by them in the future.

    Ideally the black dress any well-dressed woman counts as her "LBD" ("little black dress"), for various occasions should be as simply designed as possible so that it can be dressed up or dressed down accordingly. Before I bought my Calvin Klein dress at Ross I used to wear a black silk crepe 1960's dress I found at the Daniel Freeman Thrift Auxilary for $5.00 to all of my professional engagements. I finally had to retire it for awhile and look for an updated modern version with the same lines. That's when I found the Calvin Klein waiting for me on the Sale rack for about $20.00.

Shopping For Inspiration:
   On the day I had a doctor's appointment with my Oncologist, the creation of this outfit was on my mind, because I hadn't pulled everything together yet, so I decided to walk down to the Ross and Fallas on LaCienega Blvd. to see if I could find something inspiring. After an hour of filling up my shopping cart, from the suit, dress and cardigan rack, with about seven black, black and white and navy-blue and white polka-dotted dresses, a navy-blue pantsuit and a black and white long-sleeved Calvin Klein cardigan, I went to the fitting room to try them on.

   "Garments considered for purchase should always be tried on for fit, comfort and general appearance," wrote Hoffman. Women who've had a mastectomy and are wearing a prosthetic bra or have had reconstruction specifically need to follow this advice because they might have to make adjustments. Since I bought my black dress prior to my mastectomy, it fit differently following surgery, so I have to wear a black stretch camisole underneath it to fill it out.Initially I was frustrated about the way my dress fit, but once I tried on the camisole with it and saw that the alteration wasn't noticeable, I was happy with the addition.

   The dresses I'd selected were the same style as my Calvin Klein so I passed on them, and the suit was too big and casual so I passed on that too. I was left with the cardigan, and at $19.99, with a silhouette that flowed easily around my body, I felt it would be a perfect accompaniment to my dress. Earlier, while in the shoe section, I'd tried on a pair of white pointy toed Nine West flats accented with beige bow detailing. They cost about $17.99 and were the only shoes I saw that day that were in my budget. I tried them on again, and after visualizing them with my dress, I left the shopping area with them in my cart.

   When I got to the check-out counter I told the cashier, "I'm going to wear this black and white cardigan over a black Calvin Klein dress I bought at Ross about five years ago then I'm going to put on a pair of black tights to make these shoes pop. To tie it all together I'm going to go over to Fallas to buy some gold or pearl jewelry to wear with for extra pizazz."

   "You sound like you have it all planned out," she said.

     At Fallas I immediately went to their jewelry section and bought two gigantic pearl bracelets for $1.99 each, a black and silver pearl bracelet for $1.99, a black and brown pearl bracelet for $1.99 and a black rhinestone hair clip for $.99.

 Trying Everything On:
   That afternoon, after I got home with my haul, I still wasn't sure if my idea would work until I tried everything on in front of my full-length mirror. To complete the outfit I added a short strand of pearls my grandmother had given me for my birthday one year, the two gigantic pearl bracelets I bought at Fallas, black tights, the white and beige flats, a black leather purse and a beige suede briefcase to the black dress and the black and white cardigan. Although it looked wonderfully elegant I realized that since I had to take two buses to get to my appointment with the agency, and the intake process would take from two to three hours, I needed to wear something equally attractive but more practical for the day ahead.

   I knew I didn't want to make the same mistakes I'd made while working at The Limited, by turning black and white into a formulaic uniform, so I decided to give it a slight retro masculine/feminine feel by wearing my black and white pinstriped blazer over my off-white and black striped sweater set and a pair of black pants. I then added the strand of pearls and bracelets for glamour. Mindful of my body flaws again, I chose the sweater set because it wasn't too snug and was made out of 100% silk. The shell is a tank and the cardigan is long-sleeved so I knew I'd be comfortable en route to my appointment when worn underneath my blazer.

   At the end of my day I couldn't say that my appearance guaranteed a dream offer, through the agency, but the compliment by the placement coordinator that "I looked beautiful and exactly how I should look on the first day of any assignment" definitely gave me confidence and filled me with gratitude that someone appreciated that I'd chosen the right colors.