Conversations on our health, illness and end of life issues can lead to emotional discomfort and anxiety in the person sharing their thoughts, as well as the listener.
It is best to treat these types of "just in case" conversations when we are healthy, but sometimes they occur when we are quite wrong.
We want to share with you some information and you and your family help resources have these difficult conversations and to better understand the issues
describing your medical wishes
obviously it is better to have something in place before a disease makes you unable to express your wishes doctor
Directive Advance / Living Will :. This written, legal document that describes your wishes regarding medical care when you are unable to make these decisions. If Terry Schiavo, the 41-year-old woman who was the centerpiece of a controversial battle right to die, had completed an advance directive, and her husband and parents have not played these private decisions in a highly publicized 12 years legal drama
Health Care Surrogate :. Someone you designate as your representative to make medical decisions for you. This person may consent to transfer you to a level of care or otherwise authorized to conduct a surgery or recommended treatment. They also have access to your medical records and may also apply for benefits on your behalf. It is important to note the person you appoint does not have to be a spouse or close family member. You can name your best friend or a distant cousin, if you feel that they will better fulfill your wishes.
A health care surrogate can not consent to abortion, sterilization, electroshock therapy, psychosurgery, therapy or treatment experiences or voluntary admission to a mental health facility
If you do not confirm a health care surrogate, your healthcare team should follow the guidelines to determine a loved one. legal guardian, spouse, adult children, parents, older brother or closest relatives or friends involved in your care
proxy :. This is a written authorization to a specific person to you or act on your behalf to represent in the legal field. A durable power of attorney allows much wider powers than health substitute. It is highly recommended to consult a lawyer before drafting this document.
News Sharing your diagnosis and prognosis
Most people share news of their cancer diagnosis and prognosis after all their tests, analyzes, blood work and other assessments are complete. Tell your family can be difficult for many reasons.
Once you share the bad news, you will inevitably have to deal with their emotions. Some people will reflect your own feelings of sadness. Others will tell you about their knowledge or experience on cancer. Sometimes people with cancer say they are frustrated with their relatives, friends and colleagues with histories of everyone they've ever known who has had cancer. It is a way of people with their own feelings.
I encourage cancer patients to reflect on the different types of people in their lives, and think carefully about what they will share with whom and how. Some people need to know the details because we will rely on them as caregivers. While others may need the basics, if we depend on them for emotional support
But here's a warning :. Some of our relatives may not have the emotional resources or practices to help us. Instead, they could become a burden for you and themselves.
Tell children is another sensitive issue.
Many years of research on children and how they deal with new cancer report that they are incredibly resilient and thrive when they trust the adults in their lives to keep them informed on the issues important affecting them.
There are many resources, including books, websites and brochures that help determine the best way to talk to your children or grandchildren about your cancer.
obviously, if you need to miss work because of your diagnosis or treatment, your employer needs to know that you have a serious medical condition. However, your diagnosis can remain private if you wish. You have the right not to have your colleagues know something about your diagnosis if you choose.
Many people share the news as they enjoy the support of people in their workplace. But again, it is important to know your rights regarding disclosure.
Dealing with the end of life discussions
The fact that your cancer is incurable is another difficult discussion to have with your family, but it is an important speech so they can make decisions to offer to help with caregiving (which is usually very necessary) and to spend time with you while they can.
Ideally, your family support your choice to stop treatment if it becomes futile or decrease your quality of life. But sometimes our relatives have strong emotions about the different treatment options or that ending the processing means. Some think that you might be giving too early.
It is important to have faith in your own treatment decisions and not to participate in a treatment just because someone who loves you does not stop.
I received calls from patients near the end of their lives who want to discuss funeral plans will or other end of life concerns. I was told that the family members will not participate in these conversations, and that planning for the end of your life is pessimistic. Keeping positive is their opinion.
Have a terminal illness is difficult and scary enough without having your family restrict the discussion of important issues currently within your control. The presence of these conversations is important and can alleviate some of the understandable anxiety people feel as they face the end of their lives.
The do not resuscitate (DNR) order is one of the topics that should be discussed, and there is much confusion about what it means. For example, if your heart stops or you stop breathing, medical staff and attending required for you to start CPR. If you have already accepted and your doctor conspired to report your code "DNR" and the health care team will allow you to die naturally.
Laws may vary slightly from state to state, but generally only you and your doctor may decide to change your status to DNR, and you would need to have a serious or fatal disease do it. You should not wait until your doctor raises this question. You can put any time to clarify your understanding of what that means.
Although cancer is all too common these days, there are still people uncomfortable having discussions with their families about health issues and end of life wishes . Remember there are many resources available to guide you through these conversations.
Your cancer treatment center may have an oncology social worker may meet with you and your family and explain these forensic issues. You can download forms free advance directives.
The resolution of these problems does not give up, and there is not a sign that you are pessimistic. Instead, you are realistic. When patients are able to have difficult conversations and answer some of their end of life concerns, it can bring a sense of relief and comfort at a very difficult time.
Questions and Answers support group online in October
participants asked a number of interesting questions at the meeting of the online support group in October. Here, we include answers to some questions
Q:.? The first session of chemotherapy hard on people
A: It varies. Some people experience side effects from chemotherapy after the first session, while others do not notice the effects until the second or third session. A handful of patients may notice some mild side effects. Types of chemotherapy drugs can cause different reactions in patients with similar characteristics. Predict responses to chemotherapy is difficult, but fortunately, the side effects are mitigated with pain medication, physical therapy, and lifestyle modifications
Q :. Is it OK to be active between treatments if I feel up to it, or should I stay recover faster
A: Energy come and go between treatments, often unpredictably. Doctors often encourage mesothelioma patients to be active when they have energy, like walking, gardening, or participate in all levels of exercise, they feel able to achieve.
Some doctors even recommend physical therapy to aid recovery and improve muscle mass (which is often reduced after treatment). active and electing physical therapy stay can improve the recovery process, and based on difficult days is just as important
. Q: How long will it take for the pain and discomfort to subside after surgery that used a mesh lining?
a: Mesh liners are often used to repair the diaphragm or the lining around the heart during pleurectomy / decortication or extrapleural pneumonectomy. Pain and discomfort can be significant at first, but over time, the pain starts to subside. Some patients say it took about a year to fully recover from the pain. Hold on, and stay in communication with your doctor about your pain level to ensure appropriate medication is prescribed
Q:.? Are most mesothelioma patients become so incapable as they go into nursing homes
A: No, most patients stay at home and do not require intensive care until 'to later in the development of the disease. Most people with mesothelioma are able to stay home with the help of caregivers and medical support equipment. Hospice is available to help patients and their families with appropriate medical care at home
Q:.? Are there certain foods that can make people with mesothelioma feel better or give them more energy during treatment
A: oncology nutritionists often recommend healthy and whole foods to the following people a treatment for cancer. Consume a good amount of protein per day is also highly recommended (see next question). A diet containing a varied amount of fruits and vegetables provide a range of vitamins and other nutrients to encourage recovery and boost energy and promote overall health.
Treatments such as chemotherapy and radiation therapy can greatly affect appetite and digestion. Chemotherapy is known for disrupting digestion and appetite zap, and side effects such as mouth sores may make it difficult to eat. For these reasons, it is important for all those who follow a treatment against cancer not to overstate what they eat, as long as they are eating enough to support the recovery. If all you want to eat a day is popsicles and smoothies because mouth sores make it difficult to chew, that's OK, just do your best to consume enough calories.
Many treatment centers have nutritionists available to help cancer patients with their diet. Leave a patient advocate know if you need help finding a
Q:.? Why is protein so important in the treatment of cancer, and how do I easily incorporate into my diet
A: Your body uses amino acids, the building blocks of protein to build and repair tissues. Treatments such as chemotherapy and surgery can reduce muscle mass and disrupt biological functions, among other side effects. As such, a good amount of protein is essential to repair damage caused by various cancer treatments. Protein consumption from various sources will help the body to get the different amino acids it needs to heal and recover. And the quality of your protein substances, so opt for organic whenever possible.
People often think meat is the only source of protein, but Maureen Keane, MS and Daniella Chase, MS, the authors behind "What to eat if you have cancer," said this thinking is obsolete . The meat is considered a "complete protein", but they are also "full fat" that can perform cancer patients quickly. Plants, on the other hand, can pack a surprising amount of protein in combination with a varied amount of essential vitamins and minerals. Plants are "incomplete proteins", but means that they contain improper smallest increments of the same proteins in meat. Keane and Chace say, "plant proteins are generally low in total fat and saturated fat; [and] they are cholesterol free"
For some patients, the vegetable protein source and become fast. easy protein. animal proteins generally require the preparation and cooking to be ready to use and can deter patients consume enough protein when they are already exhausted by the treatment of cancer. Conversely, a spoonful peanut butter protein-packed or a handful of nuts are ready to eat in seconds
Here are some other quick and easy ways to add protein to your diet :.
- Store organic pre-cooked chicken or fish in the refrigerator or freezer. Just reheat when ready to eat.
- Add a handful of spinach in a smoothie. (Spinach contains 12 grams of protein per 100 calories, while ground beef contains 10 grams per 100 calories.)
- Stock the pantry with cans of beans. They quickly added to rice, wraps, soups and tacos.
- Keep small bags of nuts around a practical source of healthy protein.
