Eating well, getting exercise, taking care of your emotional health, learning to relax and coping with the effects and stress associated with any illness is important to maintaining wellness. You may find some of the suggestions listed on this page useful in helping you cope with your diagnosis.
No specific diet is recommended for people with myeloma but it is always a good idea to try to eat healthily. This may mean eating a little more of some foods, such as fruit and vegetables, and a little less of others, such as fatty foods. After a diagnosis of myeloma some people feel they should make major changes to their diet, in case this can help them overcome the disease. There is no evidence that a change of diet can alter the outlook for people with myeloma. Getting a balance between different food types is, however, important for your general health. A healthy diet includes a variety of foods: lots of fruit and vegetables, high fiber foods such as whole-wheat bread and cereals, plenty of fish and chicken and not too much red meat, fewer fatty or fried foods, and not too much sugar and salt. Eating this way can help to increase your energy levels, build up your strength and aid your recovery after treatment. You do not need to avoid foods containing calcium as this will not affect blood calcium levels, and protein taken in the diet will not affect paraprotein levels. Excessive intake of drinks containing caffeine, such as tea, coffee and soda, should be avoided. Discuss alcohol intake with your doctor or pharmacist, as alcohol should be avoided with certain medications. Caffeine and alcohol stimulate urine input and may lead to dehydration and fatigue. Drink plenty of water, up to two liters a day to help flush medications and toxins from your body.
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Some people take a general vitamin supplement if they feel they may not be getting enough vitamins and nutrients from their diet. However, you should avoid taking vitamin C in large doses (more than 500mg a day), as it will add to the acidity of your urine, which can damage the kidneys. Supplements such as cod liver oil and evening primrose oil are probably safe to take but it is best to avoid any supplements or remedies which are aimed at boosting the immune system (e.g. Echinacea) as they may have an adverse effect on your myeloma. Discuss with your doctor before you take any vitamin or other supplements just in case they affect your myeloma or your treatment.
Exercise helps keep your body fit and strong and can boost mental and physical feelings of wellbeing. The most important thing for people with myeloma to think about when planning any sort of exercise is their bones. Myeloma patients often have weakened bones and should avoid contact sports and more adventurous sports in case of injury. Improving your muscle strength is important as this will reduce the pressure on your bones. If you attend a gym, explain your situation to an instructor and ask for some advice on exercises to strengthen your muscles. Light, non-contact forms of exercise such as walking, swimming, cycling, gentle aqua-aerobics, gentle gym work, yoga and tai chi are good for overall health and for muscle and bone strengthening. Due to the specific problems associated with myeloma, you should always seek the advice of a physiotherapist or qualified sports trainer before starting an exercise programme. Warm-up and cool-down exercises before and after are important as they can help to avoid muscle strains. If you have not exercised for a while, start with small amounts to build up your stamina. See how you feel after exercising (both immediately and a day or so later) and only do what feels comfortable. You may have less energy during and after treatment and feel frustrated that you cannot do as much as you could before. It is quite normal to feel more tired after exercise and it may help you to sleep. However, it is very important to stop what you are doing immediately if you feel any pain.
Bone pain is a common problem for people with myeloma. Which bones are affected (if any) differs from person to person, but the pain is most often felt in the middle or lower back, the hips and the rib cage. Below are some ways to reduce or help you cope with your pain:
Fatigue or extreme ongoing tiredness is a very common problem for people with myeloma. It can leave you too exhausted to do the things that matter to you. It can even make it difficult to think straight and leave you feeling that you'll never get better. There are a number of things that you can do for yourself to help reduce fatigue. Make sure you are getting enough energy in the food you eat. To have energy your body needs iron to help carry oxygen through the bloodstream. Make sure that you eat a diet with enough iron (for example spinach, red meat, fortified cereals and breads are all a good source of iron). You also need to have sufficient vitamins in your diet (fresh fruit and vegetables are a good source of vitamins). Carbohydrates (such as pasta) are a good source of quick energy. Try getting a little exercise every day, as this too can help you manage your fatigue. Light exercise such as walking or swimming may be particularly beneficial. If you do not feel like walking you can still exercise while sitting in an armchair. For example, try lifting your arms and your legs, rotating your ankles and flipping your feet up and down from the ankle.
Try to use your limited energy wisely throughout the day. Consider the following:
Think about your sleeping patterns. Getting enough sleep can help improve fatigue.
Infections are more common in people with myeloma because the disease, and treatments such as chemotherapy (which can reduce your white blood cell count), can affect your ability to fight them off. You can make some changes that might reduce your chance of catching infections. This is particularly important if you have recently undergone high-dose therapy and stem cell transplantation. Try to avoid being in enclosed spaces like buses or trains when they are very busy. Ask your friends not to visit if they or anybody in their household have colds, flu or other infections such as measles, chickenpox and shingles. All food should be as fresh as possible, fruit should be washed, and meat should be cooked thoroughly to avoid picking up a stomach bug.
Tell your doctor if you think you may have an infection. A course of antibiotics from your family doctor may resolve the infection but if it is persistent you may need an intravenous infusion of antibiotics given in hospital.
Kidney problems can occur in people with myeloma for a variety of reasons. They can be caused by the myeloma itself or sometimes the drugs used to treat myeloma can harm the kidneys. A good way to protect your kidneys from damage is to drink at least two litres (six pints) of water each day. This can be quite difficult to do, so try to drink little and often throughout the day so that it becomes a habit. You should also avoid taking very large doses of vitamin C (more than 500mg per day).
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