Coping With Side Effects

Report symptoms to your doctor or nurse during clinic hours today if you are:

• Feeling very sad or very angry most of the day
• Losing interest in life because of changes in your body
• Not taking care of yourself (not exercising, dressing, or caring for your skin)

You may benefit by talking to your social worker or a mental health counselor.

• Maintain a confident and positive self image.
• Express your feelings to a trusted family member, friend, nurse, or social worker.
• Talk with other people who have had similar treatment about what they did and how they coped with changes in body image.
• List your best points. Then list your options for what you would like to try to maintain a good body image.
• Laugh! Humor is a fine way to cope. Treat yourself to funny movies, TV shows, books, or even people.
• Take advantage of programs to help you look your best during cancer treatment.

• Buy or borrow a wig. Fred Hutchinson Cancer Center provides one complimentary wig to Fred Hutch patients for hair loss. For a wig fitting, contact the Patient & Family Resource Center. Most offices of the American Cancer Society can give you information or help you get a wig.
• Learn where to buy or get a free wig or hair piece, and how to get help with head shaves and wig fittings.
• Use a headwrap. Making headwraps out of scarves is easy. A headwrap can complement your looks. The emphasis should be on color and texture rather than on complicated tying techniques. The book Beauty and Cancer, by Diane Doan Noyes and Peggy Mellody, gives instructions on headwraps (as well as skin care, makeup, clothing, nutrition and exercise).
• Try turbans, scarves, hats, or caps. Head coverings enhance appearance, protect against drafts, and help retain body heat.

• Wear colorful clothing. Chemotherapy and radiation tend to make skin pale, sallow, or ruddy. Colors and interesting patterns can decrease the intensity of changes in skin tone.
• If your face becomes very round or puffy, wear a V-shaped neckline.
• If you have lost a lot of weight, try a round or oval neckline.
• Avoid any garment that might puncture or break your central intravenous line, such as pins or front-clasping underwire bras. Soft fabrics drape best over catheters.

Select skincare products that you like that are inexpensive, fragrance-free, hypoallergenic, and alcohol-free.

• Cleanse your skin twice a day. Mild soap and water is the most basic cleanser and is especially good for oily skin. Cleansing creams are good for dry and normal skin because of their moisturizing effect. All cleansing products should be applied gently to avoid pulling the delicate surface of your skin. Use caution to avoid bruising the skin.
• Use a moisturizer to help skin retain its moisture.
• Avoid alcohol-based products.
• Avoid hot water.
• Wear sunscreen or protective clothing when outside.
• Report any skin changes, such as rash or inflammation, to your doctor or nurse.
• Get help from Fred Hutch’s oncology store, Shine, where trained staff can help you find products that are most appropriate for you. Contact Shine at (206) 606-7560. Located one block west of REI in downtown Seattle.

• Talk to your doctor before beginning any new exercise program.
• Exercise daily. Exercise is one of the simplest and most effective ways to reduce stress, increase stamina, and gain a feeling of well-being.
• Begin slowly with low-intensity exercise, such as walking. Let your body be your guide. Your body will tell you what your limits are. Don’t overdo it. A good rule of thumb is to never be out of breath; you should always be able to talk.

Call your Fred Hutch clinic or the after-hours phone number now if you feel:

• Disoriented
• Confused

Report these symptoms to your doctor or nurse during clinic hours today if you are:

• Forgetting things more quickly and more often than usual
• Finding it harder to read more than a paragraph or a page at a time
• Finding it difficult to keep your mind from wandering.

If problems persist or affect day-to-day living to a large degree, discuss the symptoms with your nurse or doctor. Or, ask your nurse or doctor about a referral to a neurophysiologist, who evaluates memory.

Learn how to cope with temporary changes in memory and concentration

• Write down important information. Keep these notes on a notepad that is small enough to keep with you at all times.
• Establish consistent daily routines.
• Have a regular sleep time and eat nutritious snacks and meals.
• Manage your stress.
• Keep distractions to a minimum.
• Ask people to repeat things.
• Keep a list of questions for your doctor. Write the answers down.
• Tape record important conversations or conferences.
• Get important information in writing. Ask people to write it down for you.
• Place notes around the house to remind you of things.
• Keep an appointment calendar.
• Use a device to remind you to take your medications, such as a watch with an alarm that can be programmed to go off at times when medications need to be taken.
• Keep things in a designated place—for example, always keep your keys in the same place.
• Be understanding with yourself, and know that these temporary changes are to be expected.
• Ask your doctor to review your medications.

• Puzzle books: Crossword puzzles are known to improve mental skills.
• Sudoku: Similar to a crossword puzzle but with numbers instead.
• Card games: Start with a shuffled deck of cards and a stopwatch. Sort the cards into separate piles, one for each suit (diamonds, clubs, spades, and hearts). Do this three times daily. A typical young adult can do this in 35 seconds. Keep practicing this task until you can do it in that amount of time!
  • Creative Whack Pack, a card pack that has ideas for stimulating creative thinking and alternate problem-solving methods.
  • Play and learn other card games such as bridge, rummy, pinochle, canasta, cribbage, black jack, and solitaire.
• Games: Play stimulating games such as chess, checkers, Scrabble, and other games you enjoy.
  • Nintendo Playstation’s Brain Age is a game developed by neuroscience researchers to improve mental abilities and hand-eye coordination.
• Hobbies: Learn a new skill, such as knitting or crocheting, or a new sport. Try writing and brushing your teeth with the opposite hand from the hand you usually use.
• Conversations: Enjoy a cup of coffee with a friend and discuss world events.
• Languages: Learn a new language. Rosetta Stone has CDs that you can purchase in various languages.
• Read books: Join a book club, or attend a book reading. A few suggestions include:
  • The Better Brain Book, by David Perlmutter and Carol Colman;
  • Whole Brain Thinking, by Jacquelyn Wonder and Priscilla Donovan;
  • Carved in Sand, by Cathryn Jakobson Ramin (the story of her struggle with early-onset memory loss).
• Web sites: A couple of suggestions include:
  • Postit Science is a site where you can try out a couple of the exercises from the Brain Fitness Program, which has been used to help veterans with traumatic brain injuries recover some of their capabilities