You Have Cancer, Now What Sophomore? #2
The SOPHOMORE #2
The following narrative is designed for cancer patients, their friends, family, caretakers, and medical professionals. This section covers in-depth information about monitoring changes in cancer patients’ bodies, including familiarity with blood work, scans, nutrition, side effects, and medication. This guide is first intended for patients who will be hospitalized for long stays, but also applies to out-patients. This is the second of four linked segments.
Prerequisite: Must have finished iLeukout’s Freshman section #1.
iLeukout does not conduct or use scientific peer-reviewed data to make any medical claims or reporting. Please confirm with your medical professionals and advisors before attempting or continuing any considerations presented by iLeukout. iLeukout does not make any pharmacological recommendations on our posts. Drug related references are detailed by what methods the author of the post or their medical team might have used. Every patient and medical team is different, and what may have worked for one patient may vary greatly for another, including benefits and side-effects.
Your first few hours or even days in the hospital may not require any treatment at all. This depends on your current health and the aggressiveness of your cancer. Several tests and scans like X-Rays, CAT scans, and so on will be conducted before any treatments begin. You will also most likely receive a Central or PICC line, if your treatments don’t involve surgery or pills alone.
Here is more information from WebMD on what to expect from this procedure.
Modern medicine has come a long way, as oncologists and nurses try to stay on top of things before they escalate. So just because your stomach hurts badly or you might get a weird side effect like having stool the color of The Joker’s hair, doesn’t necessarily mean you are facing fatality.
As a sophomore, your first few days have begun with treatments. As a freshman, you might have been a novice and were still sort of wandering around, overwhelmed with figuring out this new world. Nonetheless, it's time to start paying more attention to detail and information that may normally be missed or misinterpreted.
Top 7 things I wish I knew before starting cancer treatments
1. Kiss your privacy goodbye. From day one, you might be an open book to your medical team. Your team might have to see you fully naked sometimes, samples of blood, urine, saliva, or bodily-matter may also be taken to examine certain functions. For example, if you happen to have diarrhea, your nurses might need to collect a sample of fecal matter or poop, yes, for further examination. They do this by having you go in a container, called a hat. It isn’t as bad as it sounds.
2. Taking certain pain meds can cause big time constipation. You may get in pain, and begin a frequent pain medicine regimen, without acknowledging the side effects until later. The last thing you want on top of every other side effect you might experience is CONSTIPATION. Chemo could also cause your system to be backed up, and it is quite merciless at this level. All that excess has to go somewhere right? You may even go over a week without having bowel movements. Plus, enemas and suppositories are ill-advised during this time, because they could lead to bacterial infections that may not be appreciated by your diminishing immune system. You will need stool softeners for frequent pain killer intake. Your doctors can prescribe you several stool softeners. However, want to know a natural and delicious stool softener that can be snacked on? Prunes. A few prunes work the best maybe once or twice a day, and are actually good for you, without certain side effects medicinal stool softeners might cause. But don’t over eat them, as they will make you go too often.
3.Your hair takes a while to fall off. After treatments begin, it may take several weeks to start seeing signs of hair loss, not necessarily even the first week you start chemo. In some cases, you may never discover hair loss at all. So, if you plan on shaving it all off, just to get rid of it, you might be shaving for a while before you don’t have to anymore. This could be risky, since you increase the chances of cuts while your immune system starts diminishing.
4.You will see your doctors every day. Your team of oncologists don’t believe in a 9-5 shift, or tee times at the golf course all day. They literally make rounds and come to your room every single day to check on you and give updates and analyses. Some oncologists usually run on a three-week schedule, before a brand new team of doctors rotate to you. Your information is transferable to the new team of doctors, so don’t worry, you won’t be completely starting over.
5. During hospital stays, you could be awoken around 3 or 4 AM to draw blood from your Central/PICC line. So try not to roll over and sleep on your belly, or it will be a challenge getting through to your tangled line. Some nurses are very gentle, and if you have easily accessible attire, they can draw your blood without your ever knowing, so help your nurses to help keep you asleep.
6. For men, infertility could be an issue after cancer treatments. You may have to preserve your sperm before receiving toxins that could sometimes cause harm to the reproductive system. If you need any further help with this, your nurses might suggest or direct you in the right direction. For women, depending on age and a list of other factors, your menstrual cycles could come to a screeching halt or dramatically reduce during chemo treatments, and restart again later. Abnormal bleeding should also be monitored, as it could signify other issues such as low platelets.
7. All patients don’t have the best veins, and some nurses may struggle while trying to “thread the needle,” when attempting to draw blood. Don’t let plenty of time go as you sit there in pain and anguish, while someone is turning your arm or hand into a pin cushion. Superficial blood clots could sometimes develop while attempting to draw blood. If your nurse is struggling, please ask your them for a Phlebotomist. A phlebotomist is a specialist in collecting your blood, with less errors, and will gladly come to the rescue.
Bonus: The hospitals usually give hand sanitizers and disinfectant wipes during your hospital stay. You can take these home with you, since used items won’t be shared with other patients.
As clearly stated in our terms of use, patients are different individuals, and should please confirm with your medical professionals and advisors before attempting or continuing with any medical advice suggested from outside sources, and also research medical advice suggested.
Top 7 Things your oncology nurse may not tell you
1.We've seen a lot, so excuse us if we seem a bit numb. Like trauma nurses, Oncology nurses have watched numerous patients pass away, while also watching some of their favorite ones suffer when battling for their lives. This may have a bearing on how nurses react. Every time something goes wrong, they may not freak out like you might, because they are used to being under pressure, and have been tested in several difficult situations. Some nurses have even been faced with the feelings of not wanting to get too attached to particular patient, because losing them could be devastating. Nonetheless, most of your nurses have your best interest in mind, and they can be very cheerful and positive in the face of diversity.
2.Yes, the doctors get the final say, but don't undermine your nurses. Keep your nurses happy, don’t undermine their authority, and be respectful of what they do. They are more responsible for your direct well-being than any other medical professional. Determine the organizational structure, and find out who is the "boss" among your nurses. In some cases, the Charge Nurse usually runs the show. 3. Don't you dare hit that alert button unless you mean it. You should always call when you need help, rather than risking falling or other concerns. Nurses try to prioritize their tasks and activities throughout their shifts. Time freezes every time that call button is hit, so make sure you really mean to call. Calling 10 times in an hour for mostly things you can get yourself is not fair to your nurses who have other patients with pressing needs.
4. If you can, try not to make demands an hour before shifts start, and an hour before shifts end. This is when nurses are giving or receiving reports, and planning to make their shifts more organized for all their patients. Be mindful of this. Try to plan your day, remembering when doctors usually visit, when meals come, and when your nurses change shifts. Also, organize your days considering: oral and body care, medication, sleep, exercise, visitation, and alone time.
5. We are not all the same. No two nurses are the same, so if you can, pay attention to your nurses’ strengths and weaknesses, and strategize around them. Sometimes, there can be a huge difference between day shift and night shift nurses. For example, there are only certain nurses you can trust with delicate tasks like changing your dressings, due to their higher quality, or certain nurses may practice better hand-washing than others. Even the best treatment centers may hope all their nurses are on the same page, but that isn’t always the case. You should report malpractices when noticed.
6. We don't know it all. Yes, nurses might sneak out of your room to get more information, look something up, or ask their co-workers and doctors. Nonetheless, keep asking them questions.
7. Come back and see us. When you leave the treatment center and are healthy again, go back and see your nurses if you can. Take them a thank you card, pictures, a bowl of candy, etc. Most importantly, they would be pleased to see how well the patient they nursed back to life is doing.
Top 7 Things to remember about your central line
1. At first, there is almost no way around most of the pain, besides some pain medication. The pain that is mostly felt isn’t from the new cut in your chest or arm alone, oh no, it could be from your muscles spasms as they react to the new fancy device you were just given. The incision site could remain numb, but not the deeper tissues. Physical therapy helps. From the moment you are laying down, getting ready to undergo the procedure to implant your central line, you might need to start stretching and relaxing the muscles around your neck. Keep looking in both directions, left and right, putting one hand over the opposite ear, and gently stretching. Keep repeating this before your procedure, and after you finish. You might need to repeat this the entire first night, and most of the second day. If the muscles around your neck are not relaxed, they could react to the new foreign device and spasm. You could add bananas and pickles to your diet if this usually helps with cramping. If spasms are severe, and don’t go away, ask your doctor about the drug Flexeril, a known muscle relaxer, only after the procedure.
2.You could be awoken around 3 or 4 AM to draw blood from your central line, and possibly get some drugs.
3. Do not get your central line site wet when your counts are low, or within the first couple of months, no matter what. For the next few days and weeks, your Central line will be cleaned regularly, covered with a secure bandage, and monitored closely for any signs of infection. During showers, your nurse will help you cover your dressing, so as not to get it wet and later infected. You can also find shower coverings from brands like Shower Shield, which provides a more flexible and wider range of covering. If you ever get the central line wet, or have any signs of itching, burning, or discoloration, you should address it with your nurse immediately. Some poles have the battery life of about 4 hours when unplugged. This also depends on how many infusions are being powered at the time. So, you could ask for your nurse to unhook you from your line for about 1-2 hours, in order to exercise, and shower without being connected. Freedom!! Or you can tote your pole around for a few hours while you exercise, and get cleaned up. Most nurses will work with you on this, though sometimes, the medication you are on might be too important to get unhooked.
4. Guard your line!!! One of the most frustrating events is going through all I mentioned above, and then having to get another line, due to carelessness. No one touches it without gloves, ever. No one should come close to it without a mask, even you. While you or anyone is changing your dressing, wear masks and gloves. You don’t want it becoming infected.
5. Central lines may malfunction and cause blood clots. These could happen around 3-5 months after being in your body. If your central line is implanted for several months, be sure to be aware of blood clot signs. These include swelling, discoloration, or pain in the arm, shoulder or neck area of the side the central line is placed. If this is the case, a Doppler Ultrasound would be done, as you could be scanned for clots. If you do have clots, the central line will be removed, while you might be placed on blood thinners to help reduce future clots from forming. You might have to get a new line, if it is still needed.
6. As soon as your smart pump beeps, make sure you look and read the prompt to see why it is beeping. Your pump may just be unplugged, which can be fixed on your own, without having to call your nurse. It may have air in the line, you may just be tangled, or the infusion may just be completed. Don’t go crazy pushing any buttons on your pump. The only button some patients push is the silence button. This silences the annoying beeping for a few seconds, or minutes, but has a snooze function, and will beep again soon. This button comes in handy when your nurse is very busy and can’t get to you immediately. You don’t have to listen to several minutes of loud beeping from your pump and from the nurse call button that has been chirping for a while as well. Be sure to ask your nurse ahead of time if it is okay to use your silence button, because some infusion prompts have to be responded to immediately. Your line has inline filters that catch air bubbles. Plenty of air entering into your line during an infusion can stop your heart. Your smart pump should not allow a certain amount of air to enter your line. However, the amount of air varies by patient, but is generally not a quantity to worry about. Ask your nurse about this, especially if your pump keeps beeping for “air occlusions.”
7. The term “port” is often used to describe all kinds of central lines. This is not technically accurate, as a port is totally different. A port is an implanted catheter which remains completely under the skin, and is accessed with a prick, as medicine and blood could be taken and given from a prick in your chest area. Tunneled catheter central lines are accessed through lumens, the tentacle looking things that hang from your central line, with the bright colored caps attached to them. Those bright colored caps are a safety measure that have a piece of alcohol foam that keeps the lumens protected and sanitized. However, no need to be a wise guy right? You can just go with the universal term of “port.”
Top 7 Things to remember about hospital food
1. Just because your food is served in the hospital or a clinic, doesn’t mean it is error-proof. By the time your food gets to you, it may have gone below or above its safe temperature zone. You could also be in the shower when your meal is delivered, or your food might have been sitting in the hallway for some time before being eaten, so be sure to ask a nurse or caretaker to reheat or refrigerate your food if you can’t. It is your and your caretakers’ responsibilities to address and inspect every bite you take, especially when your blood counts are low. Several new studies suggest that fresh fruits and veggies for neutropenic patients are not as liable for certain infections, as once believed. However, you still want to LIMIT your exposure to impurities, so strategize and avoid raw fruits and veggies that have little fibers like unpeeled peaches, and broccoli. Grapes also contain plenty of dirt around the base of the fruit. With fruits, you want to look for rotten and soggy spots or discolorations. Canned fruits and properly cooked veggies might be a safer option in some cases.
2. Also avoid fresh seafood if you can, unless canned sardines, if available. Inspect your meats and beware of bones that can further injure the inside of your mouth. Some treatment centers do not allow any meats containing bones to be served to neutropenic patients.
3. Remember, certain foods like popcorn and meats can become easily lodged in your teeth. Sure, you could use a floss pick to dislodge these, BUUUUUT, if you have low platelets, you could trigger heavy bleeding if not cautious, further exposing bacteria to a gaping new entry, leading directly into your blood stream. Soooo, I’d pass on the movie theatre popcorn until counts go back up.
4. Your taste buds might go through a roller coaster ride. Some advise not to eat your favorite foods, because certain smells and tastes may forever be linked to the negative experiences you might have while going through cancer treatments.
5. Be careful about consuming certain acidic offerings like pineapples, alcohol, tomatoes, apple cider vinegar, etc. Though these might be healthy for you, they can erode your enable and the lining of your mouth, making mucositis worse. Use baking soda and sea salt to balance this chemistry when aggravated.
6. I love you, but you can wait. Here's why reaching for your favorite drinks, foods or snacks may not be best idea for you during cancer treatments. Some choices are not nutritious and helpful for your body’s rebuilding process. Yes, you may have the craziest Flaming Hot Cheetos craving at two in the morning, when you're awake and can't sleep, or maybe the wine cooler you can't wait to have. You seriously must consider the replenishment of key nutrients and vitamins, and shouldn't be working against your body in slowing down that recovery process.
7. Try to eat in moderation, since over eating could cause further problems with bloating, nausea, and vomiting.
Top 7 Exercising considerations for cancer patients
1. Walking is just so effective, yet isn’t as rigorous. Yes, you might be in pain or nauseated, completely weak, and walking may be the last thing on your mind. You will still have to exercise. Some nurses may stay on you and get you up and moving. Your body needs to stay moving, and walking is the best low-level exercise, especially when you are in the hospital. You should have a daily walking schedule that you can track during good days and bad days. If you cannot move around as often, ask for a Sequential Compression Device. A what??? This device comes with sleeves that could help prevent blood clots from forming in the legs, due to immobility.
2. Use a tracking device to track your accomplishments, and reward yourself accordingly.
3. Remember not to overexert yourself, in order not to suffer any further physical injuries. If you even think you might need help getting up, call rather than risking a fall.
4. Physical therapists are available as part of your medical professional team, and they can help with flexibility, strength training, cardio, etc.
5. Wear a mask when counts are low, especially if you are walking outside your treatment center.
6. Stay hydrated, even when on fluids from your line.
7. Be sure to stretch your muscles after working out, and rest enough, so you can keep up with a daily routine.
Top 7 Honest but scariest things you might consider when facing cancer
1. If the treatments don't work. Though survival rates are showing inclines, due to the advancements in modern technology, we still have a long way to go.
2. You could pass away. This could very well be the end. Or the beginning.
3. The rumored pain. You have heard the horror stories, and you might never be the same again, for better or for worse.
4. The actual pain. For some, you truly get really bad before feeling really good.
5. Losing close friends and family that may abandon you during this time.
6. The drugs can be so complicated, and they could change you for life.
7. The cost. You could be in debt or deeper in it after treatments.
Top 7 Things cancer patients are thankful for
This list is dedicated to the loved ones and caretakers of cancer patients everywhere. You have watched us suffer, enjoy, rejoice and endure through our good and bad days. You are the true heroes without capes or publicized valor.
1. Modern medicine. From the most sophisticated drug regimens, state-of-the-art hospital beds and functional equipment, dietary plans, technological treatment methods and equipment, including: allogenic and autologous stem-cell treatments, genomic sequencing, nanotechnology, and synthetic biology, we have come a long way with cancer research. Better research and results are coming, which could help save more lives and make cancer battles easier and less painful.
2. Donors. From blood transfusions, to platelets, and even stem-cells, we wouldn’t get far without our donors. Thank you donors, we live through you.
3. Oncologists, hematologists, doctors, nurses, phlebotomists, nurse techs, social workers, receptionists, etc. Without our medical professionals, it would be extremely difficult to get our treatments, tests, care, and recovery. A special thank you to the medical professionals in the field of Oncology. You are brave in tackling monsters, and champions at saving lives. Thank you for putting up with us :)
4. Great medicine. Patients not only have access to the medicines that treat cancer, and also the ones that make side-effects less tormenting.
5. Compassion. Financial donations and gifts from friends, families, and strangers.
6. A new beginning at life. Cancer treatments can sometimes be a reset for the body, mind, and spirit. When patients are faced with death, they might gain a new sense of life.
7. An end. Sometimes, it is the end. All patients don’t have promising prognoses, and when it’s time to go, that inevitable task can cause the most negative, but also positive outcomes. Some of us are caught fighting when it is time to go, some simply know when it is time, and recognize the light during the darkest hour.
Top 7 Clues someone is on chemotherapy
1. Finger nails are often brittle, and dark colored - black or purple.
2. Central line noticeable through a shirt.
3. Baldness including eyebrows, facial hair, pubic, arm, and legs, but rarely eye lashes.
4. Face Masks are worn when patients are neutropenic, as common particles in certain environments could cause illness or worsening of prior conditions.
5. Signs of shivering. Low Red Blood Cell counts could cause anemia, which might make someone colder than normal.
6. Signs of bruising in the arms and hands could come from blood draws or infusions, superficial vein damage, and even falls. The appearance of bruising could be a presence of thrombocytopenia, a result of low platelets. Low platelets could cause easy bruising and bleeding.
7. Shaking and quivering of especially the hands and feet can be noticed with cancer patients under certain chemo, as neuropathy from some chemo could cause trembling of the hands and feet.
As clearly stated in our terms of use, patients are different individuals, and should please confirm with medical professionals and advisors before attempting or continuing with any advice found from outside sources.
