When you were told you have myeloma, you may have felt like you were alone in the battle of your life. But in reality, there is a whole team of dedicated professionals who are behind you and ready to help you. They are the members of your healthcare team. In this section, we’ll be looking at the roles played by the different members of your team and how you can optimize your communications with your team members to become a more informed and active participant in your care.
As you probably know only too well, most healthcare professionals are very busy. Their time to talk is often limited. And most health care professionals are so used to the medical terms they use that they may forget that other people do not understand them. Here are some tips for optimizing your communications with your health care team.
When you first became ill, probably the first person you saw was your family doctor. Your family doctor helped to narrow down the possibilities of what might be wrong and provided referrals to specialists. Most family doctors see only a few, if any, myeloma patients in their practices.
A medical oncologist is a physician who specializes in the diagnosis and treatment of cancer. This doctor may be the key member of your health care team. He or she will determine your exact diagnosis and, in consultation with you and other specialists, design your treatment plan.
Because myeloma is a cancer of the blood, you may be referred to a hematologist. A hematologist is a physician who studies, diagnoses and treats diseases and disorders of the blood. Some hematologists specialize in blood cancers, whereas other may specialize in other blood problems such as clotting disorders. This doctor may be the key member of your health care team.
If you require radiation therapy, you will be referred to a radiation oncologist. As the name implies, a radiation oncologist is a physician who specializes in treating cancer with radiation therapy.
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A surgical oncologist is a surgeon who specializes in cancer operations. For example, if a tumour must be removed, you may be referred to a surgical oncologist.
If you require surgery on your bones, muscle or joints, you may be referred to an orthopedic surgeon.
Nurses may fill several important roles in your healthcare team. An oncology nurse is a specially-trained nurse who works closely with your medical oncologist, hematologist or radiation oncologist to coordinate your care, oversee your therapy and keep your physicians informed of any problems you may encounter. Other nurses may specialize as cancer educators. Nurse practitioners are nurses who have undertaken additional training in diagnosis and treatment of medical conditions.
Your treatment for myeloma will involve many medications, some of which may be oral and others which may be delivered through an intravenous line. Whether working in the hospital or the community, pharmacists are invaluable sources of information for patients and care providers. Pharmacists can help you to understand what different medications are design to do, how to take them, what effects and side effects to expect, and what to do if side effects occur.
Your dentist is an important but often overlooked member of your healthcare team. Good oral health is important at all times, and even more so when you are undergoing myeloma treatment. Infections from the teeth can drain into the lymph glands in the neck, and if your teeth and gums are not kept clean large quantities and varieties of bacteria can colonize the gums. These types of infections are an important and preventable source of problems.
If possible, it is best to identify and treat dental problems before you start chemotherapy, undergo stem cell transplant, or start taking bisphosphonates. Generally, the best time to be treated is when your hemoglobin count is 100 or more, platelet count 80 or more, and your neutrophil count 2.0 or more. Special precautions such as prophylactic antibiotics are probably required if you have a central line or catheter in place.
Dentists who work at cancer centres are familiar with the special requirements of myeloma patients, but some community dentists may not be. Speak with your dentist and clearly outline what drugs you are taking (including intravenous therapies), where you are in your therapy, and what the plans may be for the future. Encourage him or her to talk with a cancer centre specialist.
Cancer and cancer treatment can make eating difficult. You may find it difficult to eat enough – or to eat the right kinds of food – to keep up your strength. Or some medications can actually increase your appetite, making it difficult to avoid overeating. The dietitian can help you maintain the healthiest diet possible throughout the different stages of your treatment. If you are struggling with nausea, vomiting, anorexia (loss of appetite), or a dry or sore mouth, your dietitian can suggest foods or drinks to help.
Like a psychologist, a social worker or counsellor can help you deal with the many emotional changes being diagnosed with myeloma can bring. In addition, a social worker may be able to help you deal with some of the practical issues that arise, such as finding out more about your healthcare coverage.
A psychiatrist is a physician trained in the diagnosis and management of mental illness. A psychologist is not a physician, but someone who has advanced training in counseling and human psychology. Both psychiatrists and psychologists can be very helpful in dealing with the psychological, emotional or behavioural problems you may encounter. In addition to “talk therapy,” psychiatrists are licensed to prescribe medication, such as anti-depressants, if required.
Some people find that talking with their clergy or spiritual advisor can be very helpful.
Myeloma Canada is affiliated with the International Myeloma Foundation, the world's oldest and largest myeloma organization
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