Table 135 Questions about Intimacy and Infertility to Ask Your Doctor

Will cancer treatment leave me with a temporary or permanent loss of sensation If so, what can I expect Will I experience painful intercourse (due to reduced vaginal lubrication or changes in the genital tissue) If so, what can I do about the changes Will I undergo premature menopause If so, how can I treat the symptoms Will I have less feeling in my genitals If so, how will it affect me Will I be left impotent or have difficulty maintaining an erection or ejaculating If so, what can I do about...

Infertility

The ability to conceive a child is an issue with many different types of cancer, may affect both men and women, and can result from both adult and childhood cancers and treatments. Infertility can also be seen as a tragic consequence (a double whammy) of surviving a life-threatening disease. For some people infertility is a source of terrific loss and may bring about intense feelings of sadness, shame, worry, and anger. Just the possibility of future infertility can interfere with...

And Other Medical Systems

Acupuncture is one of the best examples of a nontraditional treatment that has been extensively studied and is now considered a conventional therapy. It is prescribed by medical doctors for a number of conditions and symptoms, including musculoskel-etal pain. Acupuncture has been practiced for several thousand years in China. The general theory is that there are patterns of energy flow (Chi, pronounced chee) within the body that help to maintain good health, and that disruptions in these...

Treatment of Fatigue

In 1796 Thomas Ball submitted a dissertation to the Philadelphia Medical Society on the causes and effects of sleep. Ball (who was about to become a doctor) suggested a number of remedies to produce sedative effects. First on his list was bloodletting (a formerly popular procedure in which a small incision is made in a vein and some blood is removed from the sick person), which he stated should be preferred to all other depleting remedies because we have it more under command than any other. He...

Other Modalities

Modalities are treatments that can be applied to a painful area of the body. Hot and cold packs are modalities that can be used at home. Caution is needed, though, because both heat and cold can cause serious tissue damage if applied for too long or if the temperature is extreme. Hot and cold packs should usually not be directly applied to the skin. Cold packs should not be left on for more than twenty minutes at a time, and there should be a break of at least an hour between treatments. Cold...

New or Exaggerated Behaviors

You need to not only assess your child's mood, but also look for new or exaggerated behaviors. For example, you should be concerned if your child who is usually outgoing becomes withdrawn, or if your child begins to act out at home or at school. If your child is usually neat but begins to become obsessive about keeping his or her room clean, this change could be a warning sign. (The opposite change is just as significant.) If your child usually needs prompting to bathe but now completely...

Table 72 Safe and Unsafe Physical Therapy Techniques

Modalities That Might Not Be Safe for People with Cancer Superficial heat (for example, hot packs) and deep heat (for example, ultrasound) Usually not used directly over a tumor site because of the theoretical concern that increased blood flow may encourage tumor growth. However, this issue is controversial. Massage manipulation percussion soft tissue mobilization Generally avoided in the area of a malignancy. This is another controversial issue there is also the suggestion that massage may be...

Table 111 Symptoms of Grief and Symptoms of Depression

Sleep disturbances, changes in appetite, decreased ability to concentrate, less interest in social activities, alterations in usual behavior patterns (for example, more irritable or angry) Depression Symptoms similar to those of grief but also may feel hopeless, helpless, worthless, and guilty and in some instances may have thoughts of suicide Generally waxes and wanes and the person vacillates between feeling hopeful and sad still able to enjoy activities Constant feelings of intense sadness...

Prayer

Another of my colleagues who works in the field of oncology, Dr. Jerome Groopman (probably best known for his book The Anatomy of Hope), wrote in a journal article about one of his patients who had cancer. She told him, Doctor, I'm frightened. I pray every day. I want you to pray for me. Dr. Groopman didn't know what to say. He explained, None of the training I received in medical school, residency, fellowship, or practice had taught me how to respond to Anna. . . . should I cross the boundary...

Setbacks

Recall that early in this book I mentioned that setbacks are a part of the healing process. As a rehabilitation doctor, I treat many patients with serious injuries and illnesses. Some of the people who come to see me are what we call multi-trauma patients for instance, they might have been in a car accident and have sustained several injuries. It can take months or even years to heal, and the road is usually not smooth. I often see other people who have a single, relatively straightforward...

Table 101 Potential Problems with Opioid Medications

Serious side effects of opioids can include respiratory depression (slowed breathing), so it's recommended that these medications not be used in conjunction with alcohol, antihistamines, barbiturates, or benzodiazepines. (There are exceptions if you are taking opioids, just be sure to tell your doctor about any other medications you're taking that can be sedating or cause respiratory depression.) Other side effects may include rash or itching, nausea with or without vomiting, constipation,...

Beware the Charlatans Mystics and Quacks

I do not advise people to rely solely on nontraditional practitioners, though I believe that some of them can be very helpful. I do not want to taint legitimate alternative healers, but I want you to be aware of the booming CAM industry and to recognize its long and often sordid history with respect to cancer. In Bathshebas Breast, a fascinating history of breast cancer, James Olson writes about how frightened and vulnerable cancer patients have been exploited Desperation drives cancer patients...

Your Baseline Mood

My mother and father had a deep and abiding love for each other, and when my father died, my mother was truly despondent. I remember one conversation I had with her a few months after his death, when she told me about a TV interview of Dr. Joyce Brothers that she had seen. Dr. Brothers talked about how most of us have an emotional baseline, whether it's generally happy or chronically depressed or somewhere in between. When we suffer a terrible blow, for whatever reason, our emotional status can...

Fighting Fatigue with Food

Fatigue is a common problem in people who are undergoing cancer treatment or have finished with therapy and are in the process of healing. Although a person's diet may be just one factor among the many reasons for fatigue, in some people diet plays a significant role. So, what can you do diet-wise to have more energy and endurance Consider the following suggestions Be sure you are getting enough protein in your diet. Talk to your doctor and your dietitian about your protein needs. It may help...