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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_ Are Gas Pains Normal After GI Surgery?

“Gas” pains are experienced by many GI cancer patients following surgery. These pains will likely be resolved in a matter of a few days, while the digestive system begins to “wake up” recuperate and heal from surgery.

Medications commonly administered after surgery tend to "slow the gut" thus contributing to more "gas" for many patients; therefore some of patients request to reduce the amount of pain medications (narcotics) administered.

Additionally, some of the painful symptoms associated with bloating and “gas” will begin to subside when the patient is able to take longer walks in the hospital corridors. Our digestive systems are not designed for lying in bed all day and respond better when we are able to exercise walk around a bit!

For detailed information concerning your specific medical concerns, consult with your licensed healthcare provider.

 

 

Information posted on www.pmppals.org is not intended to substitute for licensed, professional legal or medical advice. Readers are encouraged to seek the counsel of licensed professionals regarding their own personal specific legal and medical needs. Copyright© 2012 by Gabriella Graham/PMP Pals’ Network. All rights reserved. Visit us on the web at www.pmppals.org We have HOPE for YOU! J

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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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_ Should I Take Probiotics After Appendix Cancer Surgery?

Today’s question comes from Brian in the USA:

“I am recovering from CRS and HIPEC and have had several organs removed from my digestive system. I have an ileostomy, which may be ‘reversed’ in the future. I am just beginning to eat solid foods again. Like any surgical patient, I have been receiving antibiotic therapy.

Should I take probiotics?”

PMP Pals responds:

“Patients like you have specific nutritional needs. Your question is best answered by your professional healthcare team, including your surgical oncologist, and specifically, your registered dietician.

Since you have an ileostomy, you may experience a “rapid transit” of contents from your stomach and small intestine, out through your stoma. This phenomenon is also referred to as “dumping syndrome.”

If you experience this, the benefits, if any, of probiotics, or any other supplement, may be negligible as the supplement may not remain in your digestive system long enough to be absorbed and to be effective.

Ask your registered licensed dietician to review your specific needs with you. Provide your dietician with a copy of your operative report so s/he can read exactly which portions of your digestive system have been removed and “re routed” (for lack of a better description!) to determine which foods and/or supplement may be beneficial to you.

Please refer to the Nutrition pageand the Blog Library on www.pmppals.org for numerous articles pertaining to the nutritional needs of Appendix Cancer, PMP and PSM patients."

 






Articles posted in PMP Pals and on www.pmppals.org are written from the perspective of patients and their families and are not intended to substitute for licensed, professional, legal or medical advice. Patients should seek the counsel of their licensed healthcare providers.

 Copyright © 2012 by Gabriella Graham/PMP Pals’ Network/All rights reserved.

Visit us on the web at www.pmppals.org We have HOPE for YOU!

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_
AR from the USA asks:

"I had CRS and HIPEC three months ago. It's time for my first post operative check up.

Should I return to the surgical oncologist who performed my surgery, or should my check up be evaluated by a local oncologist?"

PMP Pals responds:

"While it may be preferable to return to your surgical oncologist for your first, and all subsequent, post op check ups, sometimes, due to long distances, it is not practical to travel back to the cancer treatment center hospital for your quarterly check ups.

In these cases, be sure that your local oncologist (or family physician or gastroenterologist)  communicates directly with your surgical oncologist to order the specific CT (or other) scans and laboratory tests needed to monitor your post op care.

Your post op diagnostic and monitoring (scans and "bloodwork) can be performed locally, as ordered by your local physician, and can be transmitted electronically, or by postal mail to your surgical oncologist where s/he can review them, and can report back to you and your local physician as to whether additional treatment is necessary."



Articles posted in PMP Pals and on www.pmppals.org are written from the perspective of patients and their families and are not intended to substitute for licensed, professional, legal or medical advice. Patients should seek the counsel of their licensed healthcare providers. Copyright © 2012 by Gabriella Graham/PMP Pals’ Network/All rights reserved.
Visit us on the web at www.pmppals.org We have HOPE for YOU!

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_ Does food interfere with the effectiveness of chemotherapy?

 

Appendix cancer patient, KR, from the USA, will begin systemic chemotherapy treatment, using Folfiri, within a few days. She submitted the following question to the PMP Pals’ Network:

 

“I read on the internet that some foods may interfere with the effectiveness of chemotherapy. Which foods should I avoid?”

 

PMP Pals replies:

 

“We are not aware of any foods that interfere with the effectiveness of chemotherapy.

 

1. There are a wide variety of chemotherapies. When seeking information, be sure that the information you obtain is specific to the chemotherapy prescribed to you, in this case Folfiri.

 

2. Always seek advice of this nature from your oncologist and your pharmacist.

 

3. A helpful source of information, specific to your question is the advice nurse available via the manufacturer/producer of nearly any chemo prescribed for you. The major pharmaceutical companies (e.g. Roche, Teva, etc.) provide telephone advice nurses to answer questions from patients.

 

The PMP Pals' Network does not endorse the use of online "chat rooms", "message boards", Facebook, etc. for obtaining detailed medical information. Specific medical information should be directed to one's licensed, professional healthcare team.

 

 

 

 

 

 

Articles posted in PMP Pals and on www.pmppals.org are written from the perspective of patients and their families and are not intended to substitute for licensed, professional, legal or medical advice. Patients should seek the counsel of their licensed healthcare providers. Copyright © 2011 by Gabriella Graham/PMP Pals’ Network/All rights reserved.
Visit us on the web at www.pmppals.org We have HOPE for YOU!

 

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__ RS from the USA asks:

“How long does it take to recuperate from HIPEC?
What are the post op side effects of HIPEC?”

GG responds:

“Recuperation times and side effects are as varied as our fellow patients themselves. Currently, within the PMP Pals’ Network, post HIPEC patients range in age from 30 to 80 years of age!

The most common side effects reported among our post HIPEC Pals are fatigue, nausea, medical anorexia, and weight loss; however these symptoms may related to CRS itself and can occur without HIPEC.

Here are photos of just a few of the cancer free Pals, all of whom have been treated with HIPEC many years ago.

 Here are articles written by a few of our longtime Pals who have been cancer  free, on average, ten years post HIPEC.

Contact us to request a HIPEC Pal Mentor.

For more information, please see our HIPEC Treatment Specialists page.






Copyright © 2011 by PMP Pals’ Network/Gabriella Graham. All rights reserved.
Articles published by the PMP Pals’ Network and posted on www.pmppals.org are not intended as a substitute for professional medical or legal care. Individuals should seek the counsel of licensed healthcare professionals regarding their own specific needs. Visit us on the web at www.pmppals.org
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_ Solutions for Weight Loss During Chemotherapy

Today’s question has been submitted by DG in Mumbai, India who seeks solutions for his father’s weight loss.

DG says: “My father has lost seventy pounds since his surgery and chemotherapy treatment began nine months ago. Originally his weight was 180 lbs.  Now he weighs 110 lbs.

He is halfway through a 12 cycle chemotherapy regimen for the treatment of Signet Ring Cell cancer (appendiceal.) Based on his recent CT scans, his oncologist believes the chemotherapy treatment is helping my dad. However, due to my father’s weight loss, the chemo treatment has been suspended until my father can gain at least five pounds. Although my father is trying to maintain his caloric intake, he does not have an appetite.

Do you have suggestions for how my father can gain weight?”

GG responds: “Thank you for submitting your question. We will share your question with participants in the PMP Pals’ Network who have experienced similar situations and will ask for their suggestions. In the meantime, we offer the following suggestions:

These are the three most common reasons "Pals" lose weight during and after medical treatment (surgery and chemotherapy)

-         1. Digestive distress (eg vomiting)
-         2.  Anorexia (loss of appetite, typically post surgery, and/or during chemotherapy)
-         3.  Inability to absorb nutrition (due to ileostomy, gastrectomy, or other surgical removal of critical portions of the digestive system)

From what you describe, your father may suffer from reasons #1 and #2

Reason #1 (digestive distress, vomiting) may be addressed/corrected through prescription medication to relieve nausea, as prescribed by your father’s oncologist.

Non prescription remedies for nausea include ginger tea, dry crackers, and limited, unseasoned, bland foods served in small portions.

Reason #2 (anorexia, loss of appetite) may be addressed by offering a variety of small meals and "snacks" throughout the day and noting which, if any of those foods offered, appeal to your dad.

Here are resources provided by the PMP Pals’ Network to assist patients in understanding their nutritional needs:

Review our NUTRITION page carefully for the following…

BeneCalorie: ask your father’s physician whether this may be a beneficial supplement for your dad

Lactose Intolerance :often overlooked by family caregivers, but very important for GI cancer patients, as many of us are lactose intolerant following surgery and cannot tolerate sugars, sweeteners, caffeine, chocolate, canned  commercial nutritional supplements, like Boost and Ensure, milk and other dairy products) and read the

Malabsorption diet.

These articles may also be helpful:

How can I gain weight?
and
How can I gain weight...I already drink Ensure

Please keep in mind that every patient is unique; what works for one patient may not work for another. This is why it is important to incorporate a team of healthcare providers in the coordination of your father’s care. In this case, your father may benefit from the inclusion of a licensed clinical dietician and an endocrinologist, to be included in his healthcare team.

The 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 as a substitute for professional medical or legal advice. Patients should seek the counsel of their licensed professional healthcare providers. Copyright© 2011 by Gabriella Graham/PMP Pals’ Network/All rights reserved.



 

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Why Doesn’t My Surgeon Specialist Visit Me Daily?


Most PMP Pal members choose to schedule their surgeries at university hospitals. The majority of our surgeon specialists are professors; the young physicians who do visit you daily (more commonly twice a day) are their students, who carefully report on your daily condition, under the supervision of your surgeon specialist.

Due to the detailed nature of our surgeries, it is not uncommon for our operations to last eight to fourteen hours, sometimes even longer. The time surgeons spend in the operating room does not include prep time to evaluate and plan the treatment of your individual case; this requires additional time.

The long hours in the operating room, combined with hours devoted to consulting with newly diagnosed patients in the clinic, time devoted to research studies, time scheduled for coordination and preparation of symposiums and conferences, etc, leaves little time for daily bedside visits with patients in the hospital. Therefore, frequent monitoring of the patient’s recuperation, as conducted by the nursing staff and physicians in residence/training, provides the surgeon specialist with the opportunity to supervise your recuperation without daily visits.

When your surgeon does visit you, don’t be surprised if s/he pops in very early in the morning (on the way to surgery) or very late at night (after surgery has been completed.)


Copyright © 2011 by PMP Pals’ Network/Gabriella Graham. All rights reserved.
Articles published by the PMP Pals’ Network and posted on www.pmppals.org are not intended as a substitute for professional medical or legal care. Individuals should seek the counsel of licensed healthcare professionals regarding their own specific needs. Visit us on the web at www.pmppals.org 

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