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Reconditioning in Response to Being Deconditioned

May 5, 2013 | AONN+ Blog | Side-Effects Management
Featuring:
Lillie D. Shockney, RN, BS, MAS, HON-ONN-CG
Lillie D. Shockney, RN, BS, MAS, HON-ONN-CG
Editor-in-Chief, JONS; Co-Founder, AONN+; University Distinguished Service Professor of Breast Cancer, Administrative Director, The Johns Hopkins Breast Center; Director, Johns Hopkins Cancer Survivorship Programs; Professor of Surgery and Oncology, JHU School of Medicine; Co-Creator, Work Stride-Managing Cancer at Work

When someone is diagnosed with cancer, they are informed of the various “expected” side effects they will likely experience as they travel through their cancer treatment experience. Whether it is fatigue, peripheral neuropathy, weight gain, cognitive functioning problems, sexual dysfunction, hair loss, etc, patients are expected to accept these side effects as part of the hand they have been dealt. Initially a newly diagnosed cancer patient is very willing and accepting of any and all side effects. This is usually due to the patient and their family being so frightened and focused on survival that they will put up with virtually anything in order to live through this experience. And sure enough, the side effects come, some one at a time and others in bunches. As acute treatment comes to a completion some months later, and these side effects continue to linger on, the patient’s tolerance is grown smaller than it originally was when first hearing those words “you have cancer.” Perhaps the fear of death has now passed so the clinical sequale is no longer acceptable. Additonally patients are making it increasingly clear to their oncology providers that the goal of treatment is not limited to just surviving; they want quality of life as well.

So what can be done about all of these side effects?? Usually what happens today is that as the treatment is completed the patient will be referred to rehab medicine or a sexual counselor, or someone else to work with this deconditioned tired, overweight, depressed, feet tingling patient (survivor) to get them reconditioned again back to their original baseline, if that is possible. This requires a lot of effect on therapists’ parts and on the survivor too. It is far from easy. But it raises the question of why did we let this patient get this way to begin with when it wasn’t actually necessary?? Habit. Plain old habit. It has always been done this way. Well, its time for a change. Time to be proactive. Making a referral to your rehab medicine dept early on can do a world of difference for the patient. Maintaining their activity level has proven to reduce fatigue from happening. Doing cross word puzzles has shown to improve cognitive dysfunctioning symptoms. Keeping one’s weight in check reduces risk of recurrence of their cancer. Even peripheral neuropathy today can be positively impacted by having a certified cancer rehab therapist work with your patient.

Give thought to this as you proceed in navigating your next newly diagnosed cancer patient. The only thing you really can’t proactively address and prevent is, well, hair loss.

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