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Posts by: Eleanor B. Ericson, RN

Sleep Week

Eleanor Ericson Mesothelioma NurseWhen dealing with a diagnosis of malignant mesothelioma it is vital to take the best possible care of yourself. One of the ways to do that is to get enough sleep. The amount of sleep that can provide you with optimal physical health, optimum immune function, mental health, and cognition, is what you need to obtain. This is often easier to say and to intellectually know but to achieve can be challenging.

Mesothelioma SleepSleep is a basic need of the body for physical and psychological well-being. The importance of sleep for best health cannot be underestimated. Sleep is something that has been undervalued by many of us. The amount of sleep we need varies with age. According to the National Sleep Foundation, adults age 18-64 should get between 7 and 9 hours of sleep a night. Age 65 years and older 7 to 8 hours are recommended. Infants and younger people require more sleep. Over time not sleeping, called short sleep deprivation, can lead to various health problems, including cardiovascular disease, obesity, and all-cause mortality. The immediate effects of not getting enough sleep are irritability, negativity, bad mood, inability to concentrate, short term memory loss, apathy, poor communication and questionable decision making.

Sleep and its effect on the human body is studied by sleep doctors. These specialized experts are called somnologist- from the word “somnus” meaning sleep. These physicians have additional training in the science of sleep medicine and are board certified by the American College of Sleep Medicine. The American Academy of Sleep Medicine, is dedicated to achieving optimum health through advancing the field of sleep medicine at the state and local levels.

There have been many studies conducted regarding sleep and its effects. In our culture often people admire someone who claims to get only 4 hours of sleep a night. In one study nearly 30% of adults in the United States reported that they sleep 6 or fewer hours a week.

Research has shown that long-term sleep disruptions may raise the risk of diagnosis of certain types of cancer. The findings that lack of sleep increases inflammation and disrupts normal immune function. Involved in the sleep cycle is a hormone called melatonin, which we produce with sleep, this hormone is thought to have antioxidant properties that help prevent cellular damage.

March 11-17 is Sleep Awareness Week. “Begin with Sleep” (#YourDayBeginsWithSleep), the focus of this week is to educate people about the importance of good sleep health for individuals to best achieve their personal, family, and professional goals. The week is sponsored by the National Sleep Foundation. The foundation is dedicated to improving health and well being through sleep education and advocacy.

Being diagnosed with cancer can lead to sleepless nights. In the middle of the night unable to sleep our darkest fears can seem to be reality. It is important when this happens that we realize that what we think at 4 a.m. is often shrouded in lack of sleep, and a negative hopeless frame of mind. It is important for all of us to take care of ourselves and get enough sleep for our physical and emotional well-being.

“The best bridge between despair and hope is getting a good night’s sleep.” – E. Joseph Cossman

Yoga – A Successful Treatment

Eleanor Ericson Mesothelioma NurseOne of the side effects that patients undergoing treatment for cancer often notice is fatigue. Doctors that study fatigue related to cancer treatment have found that the interventions that are prescribed fall into three categories. The first is treatment of a physiological problem like anemia, the second is drugs to stimulate the patient such as amphetamines. The third, and most successful is to suggest an exercise program such as yoga. Research is showing that yoga can help with pain and fatigue for patients undergoing cancer treatments. Used in conjunction with standard medical therapy, yoga is included as the third most popular complementary treatment used in the United States.

Yoga Cancer MesotheliomaYoga is an ancient practice of at least 5000 years, there are more than 100 different forms of yoga varying from fast paced to relaxing. The practice of yoga can help increase strength, endurance, and flexibility. Hatha is the form of yoga that most people think of when they think of yoga. The word Yoga is derived from the Sanskrit word “yuji,” meaning yoke or union. Yoga is an ancient practice that brings together mind and body. One of the premises being that mental and physical health are not just closely tied together they are equivalent. For many yoga is a low risk, high yield approach to improving overall health. Yoga has been described as a total mind -body workout that combines strengthening and stretching poses called asanas, with breathing exercises known as pranayama, and meditation or relaxing.

The past few years have shown an increase in the number of people who practice yoga. It is estimated that approximately 7.5% of U.S. adults have tried yoga at least once- nearly 4% in the previous year. A survey conducted by Yoga Alliance and The Yoga Journal, the results noted in an article in Forbes March 15,2016, stated yoga is being practiced by 37 million people in the United States up from 20 million, 3 years ago. Of that number 72% are women and 28% are men. The coasts of the United States are where yoga is most popular rather than in the middle of the country. One study identified some of the reasons people are trying yoga is 61% for flexibility, 56% stress relief, 49% general fitness, 49% overall health, 44% physical fitness, 86% experience a strong sense of mental clarity and 90% yoga is a form of meditation.

What are some of the effects of yoga on your health?

– Yoga can reduce the impact of exaggerated stress responses and may be helpful with both anxiety and depression.

– University of Utah study showed that people that have a poorly regulated response to stress are also more sensitive to pain.

– Techniques such as yoga, can help a person regulate their stress and pain responses.

– Can decrease the levels of cortisol, the primary stress hormone- helps lower levels of stress, anxiety, fatigue and depression

– Studies have shown that practicing yoga can lead to a decrease in symptoms of anxiety

– May reduce inflammatory markers in the body and help prevent pro-inflammatory diseases

– Could improve heart health- alone or with other therapies

– Improves quality of life

– Fights depression by decreasing symptoms of depression by influencing the production of stress hormones

– Reduce chronic pain increasers the secretion of melatonin a hormone that regulates sleep and wakefulness

– Improves balance and mobility in older adults

– Yoga may stimulate the vagus nerve and reduce migraine intensity and frequency- alone or with conventional therapy

– Mindful eating- yoga encourages mindfulness which may be used to help promote mindful eating and healthy eating habits

Yoga has many health benefits, is affordable, and open to people of all ages. It may help in your journey with mesothelioma.

Post-traumatic Stress Syndrome, PTSD

Eleanor Ericson Mesothelioma NursePost-traumatic stress syndrome, PTSD, is something that a lot of people associate with seeing or being involved in a traumatic event such as service in the military, it can also extend to being diagnosed with cancer. PTSD can develop at any age, and not everyone diagnosed with PTSD has been through a traumatic event. A friend or family member may experience a trauma, or a sudden unexpected death can lead a loved one to experience PTSD.

The United States National Library of Medicine defines post-traumatic stress syndrome as, “an anxiety disorder that develops in reaction to physical injury or severe mental or emotional distress, such as military combat, violent assault, natural disaster, or other life-threatening events.”

Often when a person is diagnosed with malignant mesothelioma it is after eliminating other more common diseases. This time can be an emotional roller coaster. For many it is mentally going from their usual excellent health to maybe a common condition like pneumonia, or an infection, to a diagnosis of a rare deadly cancer. The symptoms might have started as annoying, through the work up and elimination of other diseases it becomes a process that indicates a life altering diagnosis.

A recent article in the journal Cancer in November 2017, found that approximately one in five cancer patients reported symptoms of post-traumatic stress disorder within six months of diagnosis. After four years, about 6% of patients had PTSD.

In general PTSD affects approximately 3.5% or about 8 million, of the people in the United States. Not everyone that has experienced a traumatic event develops PTSD. Consisting of ongoing- chronic -or short term -acute- PTSD the symptoms can develop within one month of the traumatic event or years after. PTSD affects more women than men. Generally, the symptoms are divided into four different groups: intrusive memories, avoidance, negative changes in thinking and mood, changes in physical and emotional reactions. The diagnosis is made for adults they must have these symptoms for at least one month, at least one re-experiencing symptom. These symptoms can cause issues in everyday life. They can include flashbacks- reliving the traumatic event over and over and experiencing it physically. Avoidance symptoms which include staying away from places, events, or objects, that remind the person of the traumatic event and avoiding thoughts or feelings related to the traumatic event. The 3rd symptom includes arousal and reactivity symptoms that include being easily startled, feeling tense, difficulty sleeping, angry outbursts. These symptoms are constant, leaving the person angry and stresses and with difficulty doing activities of daily living. The fourth category of symptoms are cognition and mood symptoms which include trouble remembering key features of the traumatic event, negative thoughts, distorted feelings of guilt or blame and loss of interest in enjoyable activities. When symptoms last more than a month, interfere with your ability to function and cannot be attributed to other mental health issues, substance abuse, medical issues it might be PTSD.

Treatment for PTSD includes medications, commonly an anti-depressant and psychotherapy – talking with a competent mental health professional who is knowledgeable in PTSD. Talk therapy with a competent professional can last 6- 12 weeks but for many people it can last a lot longer. With help the symptoms can improve gradually. Support of friends and relatives is also important, letting them into what triggers your symptoms also can help.

Post – traumatic stress disorder is a very serious condition, it can upset your relationships, livelihood, and your health. It is vital that the symptoms be recognized and to seek help. PTSD can be treated and managed but not cured. Reach out get help, improve your life and the lives of those who love you!

Financial Toxicity

Eleanor Ericson Mesothelioma NurseA diagnosis of cancer can affect every aspect of a person’s life. We know that receiving a diagnosis of a rare, life threatening cancer such as malignant mesothelioma, can cause stress for both the patient and the patient’s family. Stress can be caused by many factors, physical, emotional and social. One of the goals of the patient, family and medical team when deciding on treatment is the effect on the person’s quality of life. Is the treatment going to maintain their quality of life? The stress can be significantly increased when the patient and the patient’s family also is worried about money. There are costs associated with treatment that are covered and not covered by private insurance or Medicare. These out of pocket expenses, co-pays for medications, co-pays for doctors’ visits, parking, eating at the facility, hotel rooms, are some of the examples that patients and families have to pay for when being treated for cancer. For some the effect on their personal finances can affect their choice of treatment options and their quality of life.

The cost to a patient’s health, due to the stress of financial problems created during cancer treatments is not something that is being ignored by the health care team. The impact of finances on a patient’s cancer journey is now being studied by many health care researchers. A few facts are listed below:

– The term “financial toxicity” refers to insured out of pocket expenses related to treatment- costs. It has been found that these expenses can diminish quality of life and impede delivery of the highest quality of care. Research has identified both objective financial burden and subjective financial distress as key components of financial toxicity

– The cost of cancer care in the United States for the year 2015 was 107 billion dollars.

– Keytruda – Pembrolizumab is $14,500 per month

– In 2014 cancer patients paid nearly 4 billion out of pocket for cancer treatments- total spending on cancer-related health care 87.8 billion in 2014

– In 2015 Americans spent 284 billion on prescriptions -about 9%- 32.6 billion spent on oncology drugs- another 11.1 billion spent on supportive care treatments which help with the side effects of strong chemotherapy drugs

– Newly approved cancer drugs cost an average of 10,000 dollars per month with some therapies topping 30,000 dollars per month- patients typically pay 20 to 30% out of pocket for drugs-average years supply would cost 24,000 thousand-to 36,000 thousand in addition to health insurance premiums

– Patients report lower quality of life who have financial toxicity- studies show that patients with cancer who file for bankruptcy may be more likely to die than those who do not file

– Financial difficulties that stem from dealing with cancer have an effect on people avoiding or delaying treatments, care or drugs- can lead to stress that can lead to mental and physical health problems

– 2013 study in the Oncologist found nearly half of cancer patients with insurance cut back on their spending on food and clothing or dipped into savings to pay for treatment

– Patients that have financial difficulty also have increased mental health issues

– A report commissioned by the American Society of Clinical Oncology found 27% of cancer survivors or close relatives of a cancer patient said they skipped doctor visits or had taken other steps to reduce health costs

Some of the ways that the medical system is attempting to help patients deal with this reality is trying to identify patients and screen cancer patients for financial stress. There are navigators in most hospitals that specialize in health insurance plans, and are knowledgeable about resources available. Social workers that know the community resources available are included in the health care team. General awareness has also increased to the importance of knowing the patient and his financial concerns.

Mesothelioma patients who have financial issues need to reach out for the resources that are available to them. It is vital that they use their energy to deal with their serious health challenge, and not be drained by financial concerns.

 

 

Sources:
  • U.S. News and World Report-by LacieGlover www.usnews.com/topics- July 1,2015
  • www.nerdwallet.com/blog/health/2015/06/23/behind-health-insurance- premiums-continue-pay-claims
  • www.ncbi.nlm.nih.gov/pmc/articles Financial Toxicity, Part I: A New Name for a Growing Problem S.Yousuf Zafar, MD. MHS and Amy Abenathy MD- financial toxicity the patient level impact on the cost of cancer care
  • National Cancer Institute- Financial Toxicity (Financial Distress) and Cancer Treatment www.cancer.gov/about-cancer/managing-care/track-care-costs/financial-toxicity
  • Web MD- www.webmd.com/cancer/news/20171024/many-cancer-patients-skip-treatments-due-to-cost
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