"The good news is that your condition is pre-cancerous. The bad news is that it is untreatable and I strongly recommend that you have a mastectomy."

"I'm sorry, what did you say was the good news?" The doctor's mouth continued to flap open and closed; I know he made sounds, but the words disappeared into a vortex.

Over the last couple of years I have been in and out of crowded doctors' waiting rooms, been pinched by mammogram machines, had needles shot into my body to remove tissue samples while I was held in a vice, had a large piece surgically taken out of me and my whole breast removed.

Luckily, my mother often came with me on doctor visits. Luckily my friend who works at the cancer information centre showed up with a large pile of information. Luckily my brother accompanied me through the procedures to hold my hand and get answers when my brain shut down.

"Gee, you sound really mellow after your operation."

"I don't do mellow. I'm still drugged." But even in my groggy state, I realized that there must be a better way to go through this. So I thought up 10 tips for surviving the health care system.

1. Always assume that you have fallen through the cracks, unless you get proof to the contrary. No news is not good news. It may mean that someone forgot to do something. Medical care can be complicated and need a lot of co-ordination among large numbers of people.

2. Never blame anyone. Recognize that everyone working in the system is very busy and probably stressed-out. While you are only concerned with yourself, they are juggling dozens of people, or hundreds.

3. Create positive relationships with everyone who can help you. Introduce yourself to every nurse, receptionist, technician and doctor that you will need to see again. Ask them for their first name. Remember it or record it for quick reference. Next time you see them establish rapport by using their first name and engaging them in personal chat before you get down to business. It only takes a few seconds. This will help ensure that you become more than just a file, and will give you some insight into what each person does. It also makes it easier to request things when you need to.

4. Apologise before you make a request. "I'm sorry to bother you when you are so busy, but since I hadn't heard from you, I thought I'd better check whether you were able to make the appointment." Canadians naturally apologize for anything, even when we are not responsible. It's time we learned to use the power of apology. If you say you're sorry, you can ask for just about anything - and still be perceived as nice.

5. Take someone with you and give them a job to do. For any important meeting or procedure, take a friend or family member with you. Their job is to remain sane, create rapport and ask good questions. This way, if you lose your grip, someone else still has it.

6. Use all your contacts. Surely someone you know, knows someone who knows someone who can find out what you need. At times this may be the only way to obtain information, a second opinion or to get in to see someone quickly. If you are hesitant to use your contacts, apologize for bothering them.

7. Be prepared to do a lot of waiting. Make appointments early in the day before the doctor has a chance to get behind schedule. This way you'll see the doctor before she/he gets tired and cranky. Just after lunch is okay too. Remember to take something you like to do in case you have to wait anyway.

8. Take everything your doctors say as information instead of gospel. Allow yourself time to think about it. Remember that medical professionals are trained to think about and discuss the worst possible scenarios. Ask them what each treatment is supposed to accomplish and repeat that message over and over to yourself to create a goal-oriented mindset within yourself. Write down your questions prior to the appointment and write down the answers - or ask your companion to do the writing.

9. Do what you need to do to stay upbeat and positive. It's perfectly normal to feel depressed and demoralized upon hearing bad news. I've been through shock, numbness, denying that this could be happening, panic, anger and feeling depressed. You can let yourself feel all those things, knowing that this is how you are feeling at this moment in time, and that you will move on. Continually remind yourself that you are good at healing, that you get better quickly. Notice what has improved each day and comment on it to yourself and others. While some may think this weird; you can even speak to your physical self; cheer for your immune system and thank it for sticking up for you.

10. Hang out with cheerful, upbeat and helpful people. I found it wearing having to cheer up other people when I told them I had cancer. I was also subjected to everyone's personal dogma regarding what I should do. It ran the gamut; from slavishly following every instruction from the doctor to never believing anything the doctor says.

There is only so much sympathy you can take before you begin to believe that you ought to feel sorry for yourself. Only see people who make you feel good - who make you laugh, who get you out, who bring over lovely things to eat. If someone asks you how can they help - get them to make morale-raising food, take you to a funny movie, bring over a good video. If depressing people want to come over, apologize and tell them you're not up to it.

At the beginning of last year I went through several major reconstructive surgeries, some of which were quite difficult. A few months ago my 11-year-old son was diagnosed with cancer. So far, so good - the tips have helped a lot. Although, I have to admit that it's been much harder dealing with my feelings about my son's illness than my own. While I'm able to be positive about his healing with him, his brother and the care givers, the challenge has been keeping myself positive when I'm alone.

I've been getting extra support to help me. I go to a therapist to get frustrations off my chest and insight. I shrug my shoulders and forgive myself when I forget where I'm going. I play solitaire on the computer. And I've discovered a great excuse to have a lot of little rewards. Where did I leave my pack of Werthers?