Cancer-related fatigue is a persistent sense of tiredness that interferes with daily functioning and is not relieved by rest. It affects 70-100% of cancer patients during treatment and 30% long after. Fatigue negatively impacts quality of life by reducing ability to do activities, work, and care for family. Cancer treatments like chemotherapy and radiation contribute to primary fatigue, while secondary factors include poor sleep, deconditioning, infections, and medications. Occupational and physical therapy can help manage fatigue through energy conservation, activity enhancement, psychosocial support, and exercise.
Audio and slides for this presentation are available on YouTube: http://youtu.be/Tt8WlPsohCU
Fatigue is a common side effect of cancer treatment. Fatigue from treatment can make everyday tasks and activities difficult to complete or enjoy. Join Jean Boucher, RN, an Oncology Nurse and Clinical Inquiry Specialist from the Nursing Department at Dana-Farber Cancer Institute, and discover how to manage cancer fatigue, improve sleep, mood, and nutrition habits, and boost energy levels.
Complementary Therapies for Mesothelioma presented by Kathleen Wesa, MD, of Memorial Sloan-Kettering Cancer Center at the Mesothelioma Applied Research Foundation's conference in New York, NY on September 28, 2012. www.curemeso.org
Carle General Surgery Grand Rounds presentation on palliative care symptom management, specifically pain, nausea, constipation, and malignant bowel obstruction.
Building on the lecture I gave (and uploaded) "Palliative Care: what every primary care doctor should know" I built this talk. It is geared for 1st year medical students who are learning anatomy, physiology, and perhaps some pharmacology and pathophysiology.
In this talk, I do not explicitly address hospice care - as that was provided in an online chapter for students at UMass. I will later upload another slide set on that topic.
I hope you enjoy it.
FYI- the link to the youtube video: http://www.youtube.com/watch?v=XHtHXGhTIC4
Link to PDF of the slide show: https://files.me.com/s.mak/8fzat6
Ethical Issues Regarding Nutrition and Hydration in Advanced IllnessMike Aref
Be able to discuss and clarify “pleasure feeding” with patients and their families
Identify ethical issues with continuing or stopping artificial nutrition and hydration
Understand complications of artificial nutrition and hydration that are not ethically justifiable
Be able to discuss issues of self-dehydration and self-starvation
Audio and slides for this presentation are available on YouTube: http://youtu.be/Tt8WlPsohCU
Fatigue is a common side effect of cancer treatment. Fatigue from treatment can make everyday tasks and activities difficult to complete or enjoy. Join Jean Boucher, RN, an Oncology Nurse and Clinical Inquiry Specialist from the Nursing Department at Dana-Farber Cancer Institute, and discover how to manage cancer fatigue, improve sleep, mood, and nutrition habits, and boost energy levels.
Complementary Therapies for Mesothelioma presented by Kathleen Wesa, MD, of Memorial Sloan-Kettering Cancer Center at the Mesothelioma Applied Research Foundation's conference in New York, NY on September 28, 2012. www.curemeso.org
Carle General Surgery Grand Rounds presentation on palliative care symptom management, specifically pain, nausea, constipation, and malignant bowel obstruction.
Building on the lecture I gave (and uploaded) "Palliative Care: what every primary care doctor should know" I built this talk. It is geared for 1st year medical students who are learning anatomy, physiology, and perhaps some pharmacology and pathophysiology.
In this talk, I do not explicitly address hospice care - as that was provided in an online chapter for students at UMass. I will later upload another slide set on that topic.
I hope you enjoy it.
FYI- the link to the youtube video: http://www.youtube.com/watch?v=XHtHXGhTIC4
Link to PDF of the slide show: https://files.me.com/s.mak/8fzat6
Ethical Issues Regarding Nutrition and Hydration in Advanced IllnessMike Aref
Be able to discuss and clarify “pleasure feeding” with patients and their families
Identify ethical issues with continuing or stopping artificial nutrition and hydration
Understand complications of artificial nutrition and hydration that are not ethically justifiable
Be able to discuss issues of self-dehydration and self-starvation
The lecture I gave for the Indiana University Health Joint Transplant Education and Research Lecture Series on palliative care. That's right, palliative care in transplant patients NOT at the end-of-life.
Presentation on palliative care given at the Caregiver's Conference for the Cystic Fibrosis Affiliate and Satellite Sites at Riley Children's Hospital.
Geriatric Population. Geriatric Palliative and End-of-Life Care.Michelle Peck
During your journey through this slide deck Geriatric Population. Geriatric Palliative and End-of-Life Care you will experience what it means to die badly.
After practicing as a Geriatric Clinician for over a decade what I know for sure is: Life is a tremendous gift. 100% of us are going to die. If you don't communicate your end-of-life plan, then you should plan on dying badly.
In The Cost of Dying: End-of-Life Care on CBS 60 minutes Steve Kroft interviews Doctor Ira R. Byock. “Families cannot imagine that there could be anything worse than their loved one dying, but in fact there are things worse, generally it’s having someone you love die badly.” ~Doctor Ira Byock
“Dr. Byock what do you mean dying badly?” ~Mr. Kroft
“Dying suffering, dying connected to machines, denial of death at some point becomes a delusion and we start acting in ways that make no sense whatsoever.” ~Doctor Ira Byock
A majority of Americans say they want to die at home. Why is this not happening?
Place of death should be regarded as an essential goal in end-of-life care.
Let’s explore how the end-of-life decision occurs?
For Doctors
Bernacki & Block (2014) found in their review and synthesis of best practices that physician attitudes, training, and perceptions of feeling inadequate in managing the emotional and behavioral reactions of patients all play a role. A majority of trainees were not taught how to communicate and they express strong desires to learn more. Physician barriers also include not addressing psychosocial concerns, placing focus on diagnoses, treatments, and procedures during discussions about the medical care at the end-of-life.
For Patients
Bernacki & Block (2014) found that patients who do bring up dying concerns with their physicians often meet barriers and often are not aware that they are at the end-of-life. Patients that have not set goals based on meaningful conversations about their desires may overuse life-prolonging treatment and underuse services that support quality of life.
Conclusion
Bernacki & Block (2014) found that there is a large body of evidence demonstrating that early discussions of serious illness care goals are associated with:
♛ beneficial outcomes for patients,
♛ no harmful adverse effects, and
♛ potential cost savings.
Apply & Do
To prevent dying badly start early conversations, enhance your knowledge and establish goals. Dreams are only dreams until you write them down. When you write dreams down then they become goals.
Do ♛ The Conversation Project a collaboration with the Institute for Healthcare Improvement. http://theconversationproject.org/starter-kit/intro/
Do your conversation kit now and make your loved ones aware of your wishes.
Wishing you the very best, Michelle
Bernacki RE, Block SD, for the American College of Physicians High Value Care Task Force. Communication About Serious Illness Care Goals: A Review and Synthesis of Best Practices. JAMA Intern Med. 2014;174(12):1994-2003.
Consolidating, Improving, and Novel Palliative Care: Order SetsMike Aref
A selection of slides, taken from a series of presentations, showing the evolution of consolidating and developing order sets for delivery of primary palliative care in our healthcare system.
Basics of palliative care including symptom management: pain, dyspnea, nausea and constipation; family meetings, goals-of-care, end-of-life care, and artificial nutrition.
Out-patient Primary and Specialty Palliative CareMike Aref
Presentation on primary and specialty palliative care, covering what is palliative care, basics of primary palliative care including pain and symptom management, and referral criteria for out-patient specialty palliative care.
The Family Meeting: The Procedure of Patient-Centered CareMike Aref
University of Illinois College of Medicine at Urbana-Champaign Internal Medicine Grand Rounds presentation on the elements, techniques, and tools of high-quality family meetings.
Whole Health is part of collaborative effort by the Pacific Institute for Research and Evaluation, VA Office of Patient Care and Cultural Transformation, and University of Wisconsin Integrative Health Program to transform healthcare and help people live healthier, happier lives, and more purpose-driven lives.
Learn more: https://wholehealth.wisc.edu/courses-training/whole-health-for-pain-and-suffering/
The lecture I gave for the Indiana University Health Joint Transplant Education and Research Lecture Series on palliative care. That's right, palliative care in transplant patients NOT at the end-of-life.
Presentation on palliative care given at the Caregiver's Conference for the Cystic Fibrosis Affiliate and Satellite Sites at Riley Children's Hospital.
Geriatric Population. Geriatric Palliative and End-of-Life Care.Michelle Peck
During your journey through this slide deck Geriatric Population. Geriatric Palliative and End-of-Life Care you will experience what it means to die badly.
After practicing as a Geriatric Clinician for over a decade what I know for sure is: Life is a tremendous gift. 100% of us are going to die. If you don't communicate your end-of-life plan, then you should plan on dying badly.
In The Cost of Dying: End-of-Life Care on CBS 60 minutes Steve Kroft interviews Doctor Ira R. Byock. “Families cannot imagine that there could be anything worse than their loved one dying, but in fact there are things worse, generally it’s having someone you love die badly.” ~Doctor Ira Byock
“Dr. Byock what do you mean dying badly?” ~Mr. Kroft
“Dying suffering, dying connected to machines, denial of death at some point becomes a delusion and we start acting in ways that make no sense whatsoever.” ~Doctor Ira Byock
A majority of Americans say they want to die at home. Why is this not happening?
Place of death should be regarded as an essential goal in end-of-life care.
Let’s explore how the end-of-life decision occurs?
For Doctors
Bernacki & Block (2014) found in their review and synthesis of best practices that physician attitudes, training, and perceptions of feeling inadequate in managing the emotional and behavioral reactions of patients all play a role. A majority of trainees were not taught how to communicate and they express strong desires to learn more. Physician barriers also include not addressing psychosocial concerns, placing focus on diagnoses, treatments, and procedures during discussions about the medical care at the end-of-life.
For Patients
Bernacki & Block (2014) found that patients who do bring up dying concerns with their physicians often meet barriers and often are not aware that they are at the end-of-life. Patients that have not set goals based on meaningful conversations about their desires may overuse life-prolonging treatment and underuse services that support quality of life.
Conclusion
Bernacki & Block (2014) found that there is a large body of evidence demonstrating that early discussions of serious illness care goals are associated with:
♛ beneficial outcomes for patients,
♛ no harmful adverse effects, and
♛ potential cost savings.
Apply & Do
To prevent dying badly start early conversations, enhance your knowledge and establish goals. Dreams are only dreams until you write them down. When you write dreams down then they become goals.
Do ♛ The Conversation Project a collaboration with the Institute for Healthcare Improvement. http://theconversationproject.org/starter-kit/intro/
Do your conversation kit now and make your loved ones aware of your wishes.
Wishing you the very best, Michelle
Bernacki RE, Block SD, for the American College of Physicians High Value Care Task Force. Communication About Serious Illness Care Goals: A Review and Synthesis of Best Practices. JAMA Intern Med. 2014;174(12):1994-2003.
Consolidating, Improving, and Novel Palliative Care: Order SetsMike Aref
A selection of slides, taken from a series of presentations, showing the evolution of consolidating and developing order sets for delivery of primary palliative care in our healthcare system.
Basics of palliative care including symptom management: pain, dyspnea, nausea and constipation; family meetings, goals-of-care, end-of-life care, and artificial nutrition.
Out-patient Primary and Specialty Palliative CareMike Aref
Presentation on primary and specialty palliative care, covering what is palliative care, basics of primary palliative care including pain and symptom management, and referral criteria for out-patient specialty palliative care.
The Family Meeting: The Procedure of Patient-Centered CareMike Aref
University of Illinois College of Medicine at Urbana-Champaign Internal Medicine Grand Rounds presentation on the elements, techniques, and tools of high-quality family meetings.
Whole Health is part of collaborative effort by the Pacific Institute for Research and Evaluation, VA Office of Patient Care and Cultural Transformation, and University of Wisconsin Integrative Health Program to transform healthcare and help people live healthier, happier lives, and more purpose-driven lives.
Learn more: https://wholehealth.wisc.edu/courses-training/whole-health-for-pain-and-suffering/
The presentation was directed towards Saskatchewan family physicians on exercise prescription for mental health and osteoarthritis in the primary care setting.
Understanding fatigue and an introduction to the FACETS programmeMS Trust
This presentation by Alison Nook and Vicky Slingsby, Occupational Therapists at the Dorset MS Service, explores fatigue in multiple sclerosis, the most common MS symptom. It looks at how fatigue can be managed with energy effectiveness techniques and introduces FACETS (Fatigue: Applying Cognitive behavioural and Energy effectiveness Techniques to lifeStyle),
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Triangles of Neck and Clinical Correlation by Dr. RIG.pptx
Kari Anderson, OTR/L and Megan Webster, PT
1. Managing Cancer Related Fatigue
Megan Webster, PT, Certified Personal Trainer, Certified
Lymphedema Therapist
Karl Anderson, OTR/L, MOT
April 6th, 2013
2. What is cancer-related fatigue
The National Comprehensive Cancer Network definition(NCCN):
• “A distressing, persistent, subjective sense of tiredness or
exhaustion related to cancer or cancer treatment that is not
proportional to recent activity and interferes with usual
functioning.”
National Cancer Institute: PDQ Fatigue. Bethesda, MD: National Cancer Institue. Available
at:http://cancer.gov/cancertopics/pdq/supportivecare/fatigue/HealthProfessional. Accessed March
2 24, 2013
3. Acute Fatigue vs. Cancer-Related Fatigue
‘Healthy’ Fatigue Cancer-related Fatigue
• Acute •Chronic
• Relieved by sleep and rest •Not completely relieved by sleep and rest
• Has an identifiable cause •Severe
•Mechanism poorly understood
3
4. Prevalence
• 70-100% of cancer patients are affected by CRF during
treatment
• For 30% or more, it can linger long after treatment is
completed
• Many people are fully functioning prior to cancer
diagnosis
• Treatment leads to:
− Reduced strength and endurance, fatigue, cognitive impairments
and pain
− Difficulty returning to previous activities and responsibilities
Cramp F, Danial J. Exercise for the management of cancer-related fatigue in
4 adults. Cochrane Database System Review. 2008:CD006145
5. Fatigue Affects Quality of Life
Daily activities affected included:
• Walking distances • Social activities with friends/family
• Cleaning the house • Climbing stairs
• General household chores • Running errands
• Getting exercise • Taking care/meeting needs of family
• Straightening up the house • Concentrating on things
• Lifting things • Preparing food
Curt, GA, Breitbart, W. Impact of cancer-related fatigue on the lives of patients: new findings from
5 the Fatigue Coalition. Oncologist. 2000;5(5):353-60.
6. Fatigue affecting one’s occupation and the impact
of cancer treatment on primary caregivers
• Accepted fewer responsibilities
• Reduced work hours
• Took days off work
• Stopped working altogether
• Went on disability
• Used unpaid family and medical leave time
Curt, GA, Breitbart, W. Impact of cancer-related fatigue on the lives of patients: new findings from
the Fatigue Coalition. Oncologist. 2000;5(5):353-60.
6
7. Cancer Related Fatigue
• Fatigue is a highly distressing symptom of cancer
− It negatively impacts:
• Physical performance
• Mood
• Social interaction
• Cognitive performance
• Sense of self
7
8. Types of Cancer-Related Fatigue
Primary Fatigue
• Fatigue that results from the result of a disease or medical condition.
• Fatigue that is related to your diagnosis
Cancer treatments contribute to primary fatigue
• Chemotherapy
• Radiation
• Surgery
• Blood & Marrow Transplants(BMT)
National Cancer Institute: PDQ Fatigue. Bethesda, MD: National Cancer Institue. Available
at:http://cancer.gov/cancertopics/pdq/supportivecare/fatigue/HealthProfessional. Accessed March
24, 2013
8
9. Types of Cancer-Related Fatigue
Secondary Fatigue
-Fatigue that is a result of factors beyond your diagnosis
Contributors to secondary fatigue
•Poor sleep •Depression/anxiety
•Physical de-conditioning •Emotional distress/stress
•Infection •Nutrition
•Medication side-effects
Department of Occupational Therapy, University of Illinois-Chicago 2012
9 [Materials developed by Kara Stout]
10. Types of Cancer-Related Fatigue
Cognitive/mental fatigue
-Fatigue that makes it difficult to concentrate or do activities that
involve thinking
-Not always obvious, but it is real
Common descriptors
•Sleepy brain •Haziness, dullness
•In a fog: cloudy thinking •Total confusion
•Mind goes blank •Can not think straight
Department of Occupational Therapy, University of Illinois-Chicago 2012
[Materials developed by Kara Stout]
10
11. NCCN Interventions for Fatigue
Occupational Therapy Physical Therapy
Energy Conservation Activity enhancement
− Set priorities − Initiate endurance and
− Pace/Delegate resistance exercise
− Referral to PT/OT/physical
− Scheduling
medicine
− Structured daily routine
Nutrition consultation
Psychosocial interventions
Psychological consult
− Educational and supportive
therapies
11 National Cancer Institute: PDQ Fatigue. Bethesda, MD: National Cancer Institue.
Available at:http://cancer.gov/cancertopics/pdq/supportivecare/fatigue/HealthProfessional.
Accessed March 24, 2013
12. Fairview Cancer Rehab Program
• Occupational and Physical Therapy Evaluations
− Therapists have extensive training and experience with cancer
survivors
− In depth knowledge of medical records and able to adjust your
treatments to your specific and current needs (i.e. lab values,
precautions/contraindications)
12
13. PT sessions
• Individualized exercise prescription
− Aerobic and endurance training, strength training, ROM
− Manual therapy for myofascial restrictions, joint mobilization, and
to decrease pain
13
14. American College of Sports Medicine Roundtable
on Exercise Guidelines for Cancer Survivors
Exercise during and after cancer treatment is safe and
positively impacts:
• Aerobic capacity
• Quality of Life
• Body composition
• Fatigue
• Strength
• Function
•Schmitz KH, Courneya KS, Matthews C, Demark-Wahnefried W, et al. American College of Sports Medicine
Roundtable on Exercise Guidelines for Cancer Survivors. Medicine & Science in Sports & Exercise. 2010;42(7): 1409-
1426
15. OT sessions
• Occupational Therapy:
− Energy management training
• Planning for physical and “brain” rest break
• Pacing, delegating
− Cognitive compensatory strategies
• Mapping strategies for organization of thoughts
• Problem-solving to beak down tasks into manageable parts
15
16. The Fatigue Cycle
Department of Occupational Therapy, University of Illinois-Chicago 2012
[Materials developed by Kara Stout]
16
17. How to Manage Fatigue (The Basics)
Banking and Budgeting your Energy
• Banking your energy = • Budgeting your energy =
saving energy when you deciding how to spend
can your energy
•The goal is to put energy in the •The goal is to spend energy on
bank by resting what is important to you
•Deposit energy by resting to •It can be hard to decide how to
strengthen your account use your energy
•Save energy so you can do the •Think about your activities and
things you want and need to do how much energy they require
•Always keep a little energy in the
bank for emergencies or special
17
occasions
18. Who is Fairview Cancer Rehab for?
• Significant fatigue, diminished energy, increased need
to rest
• Diminished concentration or memory
• Difficulty completing daily tasks
• Anyone who previously exercised and has difficulty
returning to work/leisure activities
• Anyone who has never exercised and doesn’t know
where to begin
18
19. Case Study
• 46 y.o. female
• Stage IIIc R breast cancer, 16 nodes positive
• R mastectomy and Ax LND, chemo/radiation
• All treatment finished 2008
• Osteopenia, hyperlidipemia, asthma, migraines
19
20. Case Study Continued
Impairments
• Cognitive and physical fatigue
• Cognitive changes with decreased short term
memory
• Weakness:
-Decreased shoulder strength
-Decreased leg strength
-Decreased endurance on 6 min walk test
20
21. Case Study Continued
Treatment: Occupational Therapy
− Energy management training
− Cognitive compensatory strategies
21
22. Case Study Continued
Treatment: Physical Therapy
-Education on how to increase aerobic capacity without undue fatigue
using bike and eliptical machines
-Training in slow progression in weight lifting to avoid lymphedema and
undue muscle soreness.
-Myofascial release to R shoulder, upper ¼.
22
24. Case Study Continued
Discharge Status Physical Functioning
• 6 minute walk test at 97% of norm
• Leg press increased from 80# to 120# (90%of norm)
• Able to vacuum, carry groceries
• Returned to health club for weight lifting and aerobic workouts 3x
week.
24
26. What can you do today?
Begin a walking program
•Start walking once each day for 3-5 minutes, at a perceived exertion
of 11-13 (light to somewhat hard)
•Add 1-2 minutes every 3 days with a goal of 30 minutes most days of
the week. As you increase the amount of time, gradually increase your
pace so you are working at a “somewhat hard” pace with perceived
exertion of 12-14
•When you feel like you need a nap, try a short walk
26
27. What can you do today?
• Decrease unnecessary muscle tension
• Strengthen your legs
-Find a chair with arms and push it up against the wall. Using your
arms as little as possible, see how many times you can go from
sitting to standing in 30 seconds
-Repeat it every other day and keep track of improvement
27
31. References
• National Comprehensive Cancer Network: NCCN Clinical Practice Guidelines in
Oncology: Cancer-Related Fatigue. Version 1.2010. Rockledge, Pa: National
Comprehensive Cancer Network, 2010.Available online. Last accessed March 26,
2013
• Cramp F, Danial J. Exercise for the management of cancer-related fatigue in adults.
Cochrane Database System Review. 2008:CD006145
• Curt, GA, Breitbart, W. Impact of cancer-related fatigue on the lives of patients: new
findings from the Fatigue Coalition. Oncologist. 2000;5(5):353-60.
• National Cancer Institute: PDQ Fatigue. Bethesda, MD: National Cancer Institue.
Available
at:http://cancer.gov/cancertopics/pdq/supportivecare/fatigue/HealthProfessional.
Accessed March 24, 2013
• Schmitz KH, Courneya KS, Matthews C, Demark-Wahnefried W, et al. American
College of Sports Medicine Roundtable on Exercise Guidelines for Cancer Survivors.
Medicine & Science in Sports & Exercise. 2010;42(7): 1409-1426
31
Editor's Notes
Introductions; Megan-posture
-MEGAN
KARL
KARL -Often patients aren’t given education on how to return to a healthy lifestyle after treatment. -Many patients may accept decreased function as the price they have to pay for getting rid of the cancer
MEGAN Telephone survey of 6, 125 households in the United States identified as having a member with cancer. Patients reporting fatigue at least a few times a month were asked a series of questions to better describe their fatigue and its impact on quality of life. Of those reporting fatigue Ninety-one percent of those who experienced fatigue reported that it prevented a "normal" life, and 88% indicated that fatigue caused an alteration in their daily routine
MEGAN Barriers: feel that it is inevitable, feel that som one would ask about it if it was important,
MEGAN often under treated even tho it has a significant impact on QOL
KARL
KARL
KARL
KARL---National Comprehensive cancer network recommends these strategies.
MEGAN
MEGAN Aerobic assess: 6 min walk/TUG, eval soft tissue restrictions, check for lymphedema Individualized tx based on former activity level and current status. Use of Nu-step, treadmill, weight machines. 2-3 x week for some 1 x eval for others.
Megan Pts told to rest…get weaker. Prescribing ex counterintuitive.. But research shows that it can reduce fatigue and improve function. You can’t sit still waiting to feel better. Am College of Sports Med released guidelines for exercise for cancer survivors for the 1 st time in July 2010. They concluded that exercise is safe during and after tx for cancer and that it positively impacts: aerobic…qol…
KARL
MEGAN
MEGAN
KARL/MEGAN(weakness) Multi dimensional Fatigue Inventory score looks at 3 types of fatigue