Sunday, 6 April 2014

Chemo Care.

Just penning a thought as it comes to me,there is nothing unique about death.Death comes to all who are born,when the time comes.Dying with dignity and with natural aging is the perfect death.

Feeding bag
Best home care and hospital care throughout the treatment was provided to Mr. Nayyar. During healing process of sutures we maintained his hygiene and hydration by moisturizing Mr. Nayyar's hands, feet, face and hair.We gave him gentle physiotherapy to make him feel active and feel good about his body image.In the evening taking him to the park encouraged him to walk.Mr. Nayyar did not like wearing the face mask out in the park to avoid attracting unnecessary attention.We would make him feel okay about it as the mask was essential to prevent airborne infections. For his tube feeding, we prepared him fresh vegetable and lentil soups under great hygiene.His tube feeding bottle had to be cleaned after every use with warm water.Mr. Nayyar would need to lie down for feeds and as this was every 2 hours, it got a bit exhausting and mundane but he complied with us.We ensured we had his ironed clothes ready for him daily as Mr. Nayyar was very particular about dressing well and we wanted him to feel in control of his life as much as possible.

21 days after, the surgeon checked Mr. Nayyar's sutures.They were healed and secure.He was referred to the Medical oncologist.Team of doctors decided on the course of chemo and radiotherapy.The standard protocol was 6 cycles of chemo with radiation overlapping the last 3 cycles of chemo.Later on we learnt that Mr. Nayyar was given what is called cytosensitive (v.s. cytotoxic) chemo to sensitize the cancer cells that were then targeted with radiation.

We gathered a lot of information from doctors, other patients and medical literature on patient care during chemo to be well equipped to look after Mr. Nayyar. During chemo,our oncologist advised us strictly not to give Mr. Nayyar any raw fruits or vegetables as these can be source of infection.We were advised to give him packed juices rather than fresh ones.A lot of emphasis was put on taking coconut water as it helps in improving platelet count.Hydration was very essential to allow for toxins to wash away from the system.The oncologist had warned Mr. Nayyar and us about the importance of nutrition during chemo as significant drop in Hemoglobin and platelets would mean discontinuation of treatment until the levels were up again.The guide was Hemoglobin not less then 10 and platelets not less than 80,000.The drawback of current chemo drugs is they cannot differentiate between normal and abnormal cells.They kill both and therefore patients have to try very hard to renew their health in between chemo cycles to get ready for the next attack on the system.These drugs cost a fortune.In a private hospital chemo and radio package touches many lakhs.

Way to Hospital for review after first Chemo cycle
The major side effects of chemo and radio are nausea and vomiting, suppression of appetite, hypersensitivity to smell and weakness/nubness in limbs.Mr. Nayyar experienced all the above side effects.The most worrying one was the nausea and sensitivity to smell of food and medicines as this affected his food intake.Even the sight of food would stimulate his nausea.At times we had to push him to gulp the soft diet to avoid the lingering smell.My daughter Rohini who was his main attendant during hospitalization, would eat her meals outside in the waiting area and quickly return to him after.She would try acupressure points on him to help with nausea, distract him with divine music, run him through his exercises with therabands and whatever it took to relieve him of the symptoms.Around this was the time when I too had commenced my chemo cycles.My other daughter Reha was my attendant.The whole ward and the staff involved in our care was in awe.It was a rare sight where both the husband and wife were undergoing treatment for cancer at the same time.Doctors would easily get confused during ward rounds.They wondered how the same daughter could be in one room with her dad one minute and then with me in my room the other minute till they realized that they were two.Every one was empathetic and extra nice to us.My chemo lasted 3 days where as Mr. Nayyar's was a week long.I would visit him in his room when disconnected from the IV drug lines.Wherever we were all together,it felt like being home away from home.

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