Today's question comes from SG in Europe:

SG asks:

"My mother has a recurrent ovarian cancer in the peritoneum.We would like to know whether HIPEC is a treatment option for her.

Has anyone had HIPEC  for reccurent ovarian cancer in Europe? Where exactly can I find a HIPEC treatment specialist in Europe?"

PMP Pals responds:

There are several HIPEC Treatment Centers of Excellence throughout Europe.

You did not mention your mother's country of residence, therefore please click here to refer to our international listing of HIPEC treatment specialists.

The HIPEC treatment surgeons are listed in alphabetical order according to their surnames."




Articles posted in “PMP Pals” and on www.pmppals.org are written from the perspective of patients and their family caregivers and are not intended to substitute for licensed professional legal or medical care. Each patient is unique and should seek the counsel of a licensed professional for their own specific case. Copyright © 2012 by PMP Pals’ Network/All rights reserved. Visit us on the web at www.pmppals.org
 

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When will I feel stronger after surgery and HIPEC?

Today’s question comes from RS from the US:

“I had CRS and HIPEC three weeks ago and have been home from the hospital for more than a week. Everything went well during my surgery and my surgeon is pleased and optimistic about my prognosis. I still feel tired from my surgery and am quite fatigued. When will I feel stronger?”

PMP Pals responds:

“Congratulations on returning home from the hospital! Generally, after we return home (away from the hustle and bustle of the hospital!) our recuperation gradually improves within the peaceful surroundings of our own home…notice that I said “gradually” as recuperation from major surgery, requires patience, patience, and more patience!

Most “Pals” tend to be active, productive people! We are not used to lying around and waiting to feel stronger!

If you have not already advised your surgeon specialist, and your local healthcare provider of your fatigue, please do so today. Aside from the obvious reason of your body needing more time to gradually heal, you may also be experiencing post-operative malnutrition (fairly common with GI and colorectal cancer patients like us) and/or anemia/iron depletion.

Your local physician, perhaps in conjunction with an endocrinologist, can test you for any conditions that may have arisen following surgery. The battery of tests will include checking your blood sugar levels, etc. These tests can all be performed with minimal stress to you.

Your physician may test you for any changes in your blood pressure, as irregularities may also contribute to your feelings of fatigue. Are you staying hydrated? Hydration can also be a factor in feeling excessively tired.

You live in the northern hemisphere and returned from the hospital during the winter. During this time of year you may experience shorter days, with less sunlight and colder weather. It is the natural human condition (not a disorder) for many people to feel less energetic during the colder season with shorter days. This factor may also contribute to your symptom of fatigue.

Recuperation rates vary among patients for a wide variety of reasons, including their age, overall health pre surgery and the caregiving/support they receive at home.

Many post op patients find it helpful to take “cat naps” during the day and to eat six or more small meals throughout the day, to help re build their stamina. Expect gradual and subtle improvements through the next five weeks.

Typically, it takes at least eight weeks, post CRS and HIPEC, for a patient to regain approximately 80% of their pre surgery energy. Your improvement will continue throughout year!

We are optimistic about your future and will congratulate you on looking forward to the spring season with improved health!”


Articles posted in “PMP Pals” and on www.pmppals.org are written from the perspective of patients and their family caregivers and are not intended to substitute for licensed professional legal or medical care. Each patient is unique and should seek the counsel of a licensed professional for their own specific case. Copyright © 2012 by Gabriella Graham/PMP Pals’ Network/All rights reserved. Visit us on the web at www.pmppals.org

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_ Why Am I Still Fatigued After CRS and HIPEC?

AR, age 50+ asks today’s question about post op fatigue. She had CRS and HIPEC four months ago, has returned to work and feels very tired at the end of her day.

“I find it to be challenging, four months post-op, to work all day, then complete my chores at home. Is it normal to feel this tired four months after surgery?”

GG responds:

“As in any case, consult with your physician to determine the cause of your disease. Among other non invasive tests, laboratory “blood work” tests can determine whether you are anemic, have a thyroid imbalance, or other possible contributors to fatigue.

You experienced a very major surgery sixteen weeks ago. The recuperation process for such a complex surgery is gradual.

Most patients who experience CRS with HIPEC are between the ages of 45 and 65 years old. I remind our fellow ‘Pals’ (with a dose of humor) that ‘we aren't 19 years old anymore!’ In other words, we don't ‘bounce back’ as quickly from major surgery as we might have when we were 20 or 30 years younger.

Additionally, recuperation may tend to "feel" a bit slower now during the winter months when many people feel sluggish in general.

Be patient with your recuperation.

By the time your one year post op anniversary comes around, you will feel much better and you will be in awe of yourself when you look back and reflect on your surgery and recuperation!

You are a cancer survivor!

The PMP Pals are optimistic for your healthy and happy future!

 

 

 

 

 

For more information on this topic see “When Will I Feel Stronger After Surgery?” on www.pmppals.org

 

 

 

Articles posted in “PMP Pals” and on www.pmppals.org are written from the perspective of patients and their family caregivers and are not intended to substitute for licensed professional legal or medical care. Each patient is unique and should seek the counsel of a licensed professional for their own specific case. Copyright © 2012 by Gabriella Graham/PMP Pals’ Network/All rights reserved. Visit us on the web at www.pmppals.org

 

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_ FAQ: “Does CRS and HIPEC Cause Dental Sensitivity?

Brian from the USA submits today’s FAQ. He was treated with CRS and HIPEC at a cancer treatment center last month, and has experienced dental sensitivity during his recuperation.

Q: “My teeth have been very sensitive to hot and cold following my surgery, a few weeks ago. The pain was more pronounced during the first two weeks following surgery, while I was hospitalized, yet continues to a lesser degree now that I am recuperating at home.

Have other ‘Pals’ experienced dental sensitivity after surgery? Is this a side effect of HIPEC? Neither my surgical oncologist, nor his assistant, have ever had a post op patient complain of this symptom before.”

Pal Patient, and Dentist, Dr Robert Rauch, USA, provides today’s response to this question:

The PMP Pals’ Network (established1998) has never received a complaint about post op dental sensitivity before. We suspect there is another cause for the sensitivity you are experiencing, and that it is not related to CRS HIPEC.

We suggest you schedule an appointment to consult with your personal dentist.

In the meantime, consider using Sensodyne, or a similar brand of toothpaste, specifically developed to protect against, and to provide relief from, dental sensitivity.

It is possible that the pain and sensitivity you are experienced is caused by clenching your jaw and/or grinding your teeth; common reactions to stress and tension. Patients may feel stressed during the weeks immediately following surgery. Some patients don’t recognize or realize when they are clenching their jaw during their waking hours, or, while sleeping. Your dentist can create a bite guard, customized to comfortably fit you, to alleviate this problem, if it is determined to be the source of your discomfort.

Your dentist can also examine your teeth to determine whether there is any other underlying source (eg an infection) as a possible cause of this pain.”



Robert Rauch, DDS is an Appendix Cancer patient, has personally experienced CRS and HIPEC, and serves as a Pal Mentor for the PMP Pals’ Network. He has been a dentist, in private practice for more than 30 years. Dr Rauch is the author of several books, including "SMILE: Be true to your teeth and they will never be false to you" and “Spiritual Signs and Lessons of a Survivor, Parts I and II.” Visit the “Recommended Reading” link on www.pmppals.org to order these inspirational books.

Articles posted in PMP Pals and on www.pmppals.org are written from the perspective of patients and family caregivers and are not intended to substitute for professional, licensed legal and/or healthcare advice. Patients should seek the counsel of their licensed professional consultants regarding their specific needs. Copyright © 2012 by PMP Pals’ Network/All rights reserved

 

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JK inquires “I am considering having HIPEC but am concerned about the risks of fistulas, adhesions and other side effects I have heard about."

GG responds " HIPEC has become the standard of care for many colorectal cancer and peritoneal surface malignancies. As is the case with any medical procedure, it is important to seek the counsel of one or more specialists in this field before deciding whether HIPEC may be beneficial to you.

As you know there are no guarantees regarding outcome, and any medical procedure, even "minor" ones, include risks. Fistulas and adhesions can occur whether or not patients receive the HIPEC treatment.

The availability of the HIPEC treatment has become more common throughout the United States, in particular, during the past five years.

Please be aware that simply because a surgeon or treatment facility is listed as a HIPEC treatment provider on a website does not indicate whether or not that surgeon/provider is as experienced as those surgical oncologists who have administered HIPEC for a decade or longer.

The purchase and acquisition of HIPEC treatment administration equipment, by any particular HMO, hospital or clinic, does not necessarily indicate that the provider is as experienced as those surgeons who have long standing relationships with university affiliated research hospitals and treatment center.

The PMP Pals' Network makes every effort to ensure that HIPEC Treatment providers posted on www.pmppals.org have substantial experience. In in most cases we post profiles for only those surgeons who have performed hundreds of HIPEC treatments.

In addition to selecting an experienced and reputable surgical oncologist, a pro active patient will also interview the nursing supervisor for post operative care, as, after surgery and the HIPEC treatment have been completed, the majority of direct patient care will be provided by the nursing staff.

Prior to scheduling a surgery date, the pro active patient will inquire about the nurse to patient ratio, the RN (Registered Nurse) to NA (Nurses' Aids) ratio for the day and night shifts. It is also prudent to inquire about infection rates and other topics of concern (see the PMP Pals' Network Handbook "Preparing for Surgery") for surgical candidates.

Every patient is an individual and each case is unique. Discuss your options with one or more specialists, then proceed with the treatment plan that you are comfortable with.”





Articles posted in PMP Pals and on www.pmppals.org are written from the perspective of patients and their family caregivers and are not intended to substitute for licensed, professional legal or medical advice. Individual should seek counsel from licensed professionals regarding their specific needs. Copyright © 2011 by Gabriella Graham/PMP Pals' Network/All rights reserved. Visit us on the web at www.pmppals.org

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Today's question comes from Dr XYZ in the US who writes: "I perform an average of two HIPEC procedures each month. Why am I not listed on www.pmppals.org?"

GG responds:

"All treatment specialists are welcome to provide their CVs for consideration in being posted on www.pmppals.org However, we do not guarantee that we will post all requests sent to us. We prefer to list those surgeons who have performed at least one hundred or more HIPEC procedures, the majority of whom average several HIPEC treatments per week. Please refer to our current international listing of HIPEC Treatment Centers and Providers.

We will be happy to evaluate your request again in the future after you have had an opportunity to gain more experience or transfer to a treatment center where the HIPEC treatment is provided on a weekly basis, and have a fully experienced support staff to provide appropriate post treatment care.
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Question of the day: “When will I feel better?”

Patricia describes herself as a fit, 48 year old marathon runner. She experienced symptoms common to Pseudomyxoma Peritonei a few months ago. Six weeks ago she experienced CRS and HIPEC treatment. Her surgeon specialist has provided her with a good prognosis and expects her to make a full recovery. However, now, during the last week of December, and having had surgery in mid November, Patricia brings the following question to the PMP Pals’ Network:

“I am feeling frustrated with the recuperation process! Although my surgeon tells me I am making good progress, I thought I would be feeling more energetic by now! I am looking forward to resuming marathon running. When will I ever feel strong again?”

GG responds:

“Patricia, if you have been thoroughly examined by your healthcare provider(s) and it has been determined that your recuperation is progressing on schedule, then, it appears, the malaise you are experiencing is common. You experienced CRS and HIPEC only six weeks ago!

You are not alone in how you feel, especially at this time of the year. Patients often feel depressed while recuperating during the winter months. Most cancer patients are used to living active and productive lives, and many lack the patience to set aside several weeks, or even months, to recuperate from treatment. “Patients” need to exercise “patience!”

To be frank, your body has experienced the trauma of several hours of major surgery followed by HIPEC. The fact that you were in excellent physical condition pre op is to your advantage. Your pre op physical fitness training will serve you well! However, again being frank, at the age of 48 (and the mid forties are a common age to be diagnosed with this particular disease) our bodies don’t “bounce back” as quickly as they did when we were 19!

Browse through the photo galleries on our Couples and other Support Group pages on www.pmppals.org to see the smiling faces of other patients who have been in your shoes...the pix will give you something to look forward to!


In conclusion...

1) Be patient with yourself recovery,

2) Recognize that the post op recuperation discomfort is a temporary condition

3) Set goals for the coming year!

We are optimistic about your future!



Articles posted in “PMP Pals” and on www.pmppals.org are written from the perspective of patients and family caregivers and are not intended to substitute for professional, licensed legal or medical advice. Each patient’s case is unique, therefore individuals should seek the counsel of their own healthcare providers. Copyright © 2010 by Gabriella Graham/PMP Pals’ Network. All rights reserved. Visit us on the web at www.pmppals.org
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