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Preparing for Chemotherapy

Posted 5/27/2015

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  This is a column that I wrote some months ago for Cancer Today. I have been thinking about it, and was pleased to find it in my files, as I spent time yesterday talking with two women who are about to begin chemotherapy for the first time. As anyone who has been through this knows, the anticipating is worse than the actual event, and those last days before starting are really tough.

Here is the important thing: It won’t be as bad as you imagine. Most new cancer patients are more frightened by the prospect of chemotherapy than by any other part of their treatment. We have all seen too many movies or read too many books in which the hero was devastated by chemo. Times have changed. I remember the days when we gave patients little buckets as they left the Infusion Area, knowing they were never going to make it home before getting sick. Now most people go through months of chemotherapy without ever vomiting and some are never even nauseous.

Many women are more distressed by the prospect of hair loss than by any other side effect. Sadly, there is little that can be done to prevent alopecia from some chemo drugs, but there are many ways to manage the loss itself and then to cover a bald head. Email me if you would like to receive more information and suggestions about this.. 

There are strategies to prepare yourself and your household for the months of treatment. Even though you are likely to feel relatively well most days, there will be some when you are more fatigued or unwell, and planning can help. Here are ideas:
1. Talk with your doctor about the specific drugs that you will receive. Side effects vary enormously, and there is no point in worrying about something that is irrelevant to your care.
2. If you will be losing your hair, plan in advance how you want to manage it. Make sure that you have a wig or hats or scarves in your house before you are likely to need them. 
3. Cook ahead and freeze some portion-size meals. Think comfort food: soups, macaroni and cheese, other favorite pasta dishes.
4. Buy a range of beverages. It will be important to drink lots of fluids, and you want a choice. Ginger, mint, or chamomile teas may be soothing; plain water may carry a metallic taste, and mixing carbonated water with a little juice usually goes down easier.
5. Consider treating yourself to a new set of very soft sheets. Naps will be even nicer.
6. Buy a comfortable bathrobe or set of sweats to wear on your less-good days.
7. A good gift would be a Kindle or some other kind of tablet reader. Even better would be an iPad with many entertainment choices. These are portable, easy to carry to appointments, and light to hold.
8. Think about small treats and plan one for a day or two after each treatment.
9. Do not expect to complete any lingering projects while you are home. No one ever organized decades of photographs or cleaned out the attic during chemotherapy.
10. Eliminate any unnecessary tasks. You are excused from sending holiday cards or even writing most thank you notes.
11. If there are annual jobs that you can do ahead, do so.
12. Assign jobs to your children. Even little ones can set the table or bring you a glass of water or rub your back. They will feel better if they feel helpful and included. Older children can rake leaves or do laundry to make simple meals.
13. Have more than one talk with your spouse or partner about allocating responsibilities. You will not be up to maintaining your usual share, and s/he will need to do more. Yes, this is difficult, and yes, it is necessary.
14. Recognize that different friends will be helpful in different ways. Play to their strengths.
15. Accept all offers of assistance and learn how to ask for help. Sign up for one of the online support networks (www.lotsahelpinghands.com or www.carecalendar.org) so that your friends can easily volunteer to help.

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