Effective Symptom Management:working with your teamSuzana Makowski, MD
Goals• What are your goals for todays talk?• Pain and other physical symptoms• Psychological, spiritual, and social concer...
Managing Pain• It is common• Barriers to treatment are many• What can you do?    • Keep track of your pain and use of medi...
What doctors need toknow about your Pain• Location• Intensity: how bad is it?• Quality: what does it feel like?• Timeline•...
Understanding PainManagement                     Definitions:                     • Adjuvant                     • Non-opi...
Opioids• Addiction versus dependence versus tolerance• Long-acting and short-acting (immediate release)• Pill/liquid versu...
Other treatments for pain
Pain - other treatments• Radiation therapy• Interventional pain (anesthesia)   • Nerve blocks   • Intraspinal medicine/pum...
Things to look out for• Sudden changes in pain intensity or location• New weakness• New incontinence of urine or stool    ...
Gastrointestinal symptoms• Nausea• Vomiting• Anorexia (loss of appetite)    • Megace    • Dexamethasone    • Small, freque...
Weakness and fatigue• Let your doctor know• How are you sleeping?• There are many causes and treatment is targeted when  p...
Psychological symptoms• Anxiety, fear, uncertainty• Depression, sadness, grief• Concern for family and future• Dignity• Re...
Your team• Doctors• Nurses• Social worker• Psychologist• Family, friends, chaplains• When you need more help: palliative c...
What is palliative care?• Treatment that focuses on alleviating suffering, improving  sense of well-being• It is available...
Other resources• The Center for Mindfulness• www.cancer-pain.org• www.getpalliativecare.org
Summary• Work with your team... Were here to help• Treat and identify symptoms early:   • pain, fatigue, GI symptoms, psyc...
Thank youQuestions?
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  1. 1. Effective Symptom Management:working with your teamSuzana Makowski, MD
  2. 2. Goals• What are your goals for todays talk?• Pain and other physical symptoms• Psychological, spiritual, and social concerns• Where to turn?
  3. 3. Managing Pain• It is common• Barriers to treatment are many• What can you do? • Keep track of your pain and use of medicines • Work with your doctor, nurse, and pharmacist - team approach • Address your worries
  4. 4. What doctors need toknow about your Pain• Location• Intensity: how bad is it?• Quality: what does it feel like?• Timeline• What makes it better/worse • What have you tried, were there side effects...
  5. 5. Understanding PainManagement Definitions: • Adjuvant • Non-opioid: acetaminophen (Tylenol) ibuprofen or naprosen • Opioid: morphine, oxycodone, fentanyl, hydromorphone (Dilaudid)
  6. 6. Opioids• Addiction versus dependence versus tolerance• Long-acting and short-acting (immediate release)• Pill/liquid versus IV• Side effects: • constipation - doesnt go away • Sleepiness, nausea • Less common: confusion, twitching (myoclonus)
  7. 7. Other treatments for pain
  8. 8. Pain - other treatments• Radiation therapy• Interventional pain (anesthesia) • Nerve blocks • Intraspinal medicine/pumps• Non-pharmacologic • Physical therapy, including TENS, compresses • Psychological/behavioral therapy • Complementary or alternative therapy
  9. 9. Things to look out for• Sudden changes in pain intensity or location• New weakness• New incontinence of urine or stool Call your doctor right away
  10. 10. Gastrointestinal symptoms• Nausea• Vomiting• Anorexia (loss of appetite) • Megace • Dexamethasone • Small, frequent meals, plastic/wooden utensils• Constipation • Senna & colace • Yakima paste
  11. 11. Weakness and fatigue• Let your doctor know• How are you sleeping?• There are many causes and treatment is targeted when possible • Anemia • Insomnia • Anxiety, depression, stress • Other...
  12. 12. Psychological symptoms• Anxiety, fear, uncertainty• Depression, sadness, grief• Concern for family and future• Dignity• Resilience and hope
  13. 13. Your team• Doctors• Nurses• Social worker• Psychologist• Family, friends, chaplains• When you need more help: palliative care
  14. 14. What is palliative care?• Treatment that focuses on alleviating suffering, improving sense of well-being• It is available at all stages of illness• It can be offered alone or during other therapies/treatment in the hospital, and sometimes at home or in a clinic• It is a team approach - lending support to patients and their family
  15. 15. Other resources• The Center for Mindfulness• www.cancer-pain.org• www.getpalliativecare.org
  16. 16. Summary• Work with your team... Were here to help• Treat and identify symptoms early: • pain, fatigue, GI symptoms, psychological concerns Youre not alone We want to help We can help
  17. 17. Thank youQuestions?

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