Wellness: Taking care of yourself
Eating well, getting exercise, taking care of your emotional health, learning to relax, and coping with the effects and the stress associated with illness are important to maintaining wellness.
You may find some of the suggestions on this page useful in helping you take the best possible care of yourself.
Although there is no specific diet that is recommended for people with myeloma, healthy eating habits are always a good idea (for all of us!). That may mean eating a little more of some foods, such as fruits and vegetables, and a little less of others, like fatty foods.
Some myeloma patients feel that they should make major changes to their diet, believing that it may help them overcome the disease. However, there is no evidence that a change of diet can alter the outlook for people with myeloma.
That said, maintaining a balance between different foods is important for your overall health.
What does a healthy diet look like? It includes a variety of foods, including:
- Lots of fruits 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.
- Less sugar and salt.
Eating this way can help give you more energy, build up your strength, and aid in post-treatment recovery.
There's no need for you to avoid foods that contain calcium, since they have no effect on blood calcium. Likewise, foods containing protein do not have an impact on paraprotein levels.
You should, however, avoid drinking too many beverages that contain caffeine, like tea, coffee and soft drinks. As for alcohol consumption, that's something you should discuss with your doctor or pharmacist, because alcohol should be avoided with certain medications. Caffeine and alcohol are also known to increase urination, which may lead to dehydration and fatigue.
Be sure to drink plenty of water – up to two liters per day – to help flush medications and toxins out of your body.
Some people take a multivitamin supplement when they feel they may not be getting all the vitamins and nutrients they need from their diet.
You should be careful, however, not to take large doses of vitamin C (i.e., more than 500 mg per day). Doing so will add more acidity to your urine, which could damage your kidneys.
Supplements like cod liver oil and evening primrose oil are probably safe to take, but it's best to avoid any supplements or remedies that are aimed at boosting the immune system (e.g., echinacea), which can negatively affect your myeloma.
Because vitamins and/or supplements can have an impact on your myeloma and/or its treatment, be sure to always consult your doctor before taking any of these substances.
Exercise helps keep your body fit and strong. It can help boost physical and mental wellbeing. And it can be fun!
The most important thing to consider when planning any sort of exercise is the impact of the activity on your bones. Myeloma weakens the bones, making them more vulnerable to fractures. That's why it's wise for you to avoid contact or more adventurous sports that place you at higher risk of injury.
A very good way to reduce pressure on your bones is by strengthening your muscles. If you attend a gym, be sure to explain your situation to your instructor, and to ask for advice about exercises that can help you improve muscle strength.
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If you haven't exercised in a while, take it slow at first and give yourself time to build up your stamina. Pace yourself. See how you feel immediately after exercising and a day or so later, and only do what feels comfortable.
If you have less energy during and after treatments, and can't do as much as you could before, don't get too discouraged or frustrated. It's normal to feel more tired after exercise, and may actually help you sleep.
Always remember that it's important to listen to what your body is trying to tell you. If you feel any pain, stop what you're doing immediately.
Coping with pain
Bone pain is common in people with myeloma. Although the bones affected can vary from one person to another, most patients experience pain in the middle or lower back, the hips, and the ribcage.
Tips to help reduce pain and/or help you cope with it
- Take prescribed painkillers regularly, or as required.
- Try not to let the pain take hold before taking them, as they won't be as effective.
- If you find your painkillers are not providing the relief they should, go back to see your doctor or nurse. There are many different pain-relieving medications available.
- Be honest with your doctor or nurse about any pain you may be experiencing.
- Don't feel like you have to put on a brave face. Remember, your medical team is there to help you!
- Learn to relax.
- Meditation, visualization, relaxation, or a combination of these can be helpful in relieving pain, when practiced regularly.
- Avoid worrying.
- Anxiety and stress can make pain worse.
- Find time to talk about your fears and worries with people who are close to you, or with your doctor.
- Get a massage.
- A gentle massage can help relax you and relieve your pain.
- Choose an experienced therapist, and explain your situation to him or her.
- Take your mind off the pain with a pleasant distraction.
- Watch television or a favourite film, listen to music, chat with a friend, etc.
- Apply heat or cold.
- Hot water bottles and ice packs can be effective pain relievers. Wrap them in a towel before placing them on the skin.
- The relief may be short-lived and you may need to alternate between hot and cold.
- Make yourself comfortable.
- The way you sit or lie down can affect your pain.
- If you are uncomfortable, change positions or ask someone to help you, if required.
- Consider comfort aids, like special v-shaped pillows for use in bed and when sitting.
Coping with fatigue
Fatigue or extreme ongoing tiredness is very common in people with myeloma. It can leave you too exhausted to do the things that matter to you. It can make it hard to think straight, and leave you feeling like you'll never get better.
Tips to help reduce fatigue
- Make sure you're getting enough energy from the foods you eat.
- In order to have that energy, your body needs iron to carry oxygen through the bloodstream. That's why your diet should include iron-rich foods, such as spinach, red meat, and fortified bread and cereals.
- You also need an adequate amount of vitamins, which you can get from fresh fruits and vegetables.
- Carbohydrates, like pasta, are a good source of quick energy.
- Try to get a little exercise every day.
- Exercise (especially light exercise such as walking or swimming) can help you manage your fatigue.
- If you don't feel like walking, there are exercises you can do while sitting in your armchair. Lifting your arms and legs, rotating your ankles, and flipping your feet up and down from the ankle are just some examples.
- "Ration" your limited energy wisely throughout the day. Here are a few suggestions:
- Try to do the things that matter most to you each day, and spread chores over a period of time.
- Tell your family and friends that you don't have the energy to do the things you used to do, and ask for their help.
- Wear clothes that are easy to put on and take off, and sit down to get dressed.
- Plan rest periods during the day.
- Prepare food when you have the energy, and freeze meals for when you are too tired to cook.
- Eat small quantities often, and use ready-made meals or snacks when necessary.
- Try to sit down while doing chores like ironing and preparing food.
- Gather all the things that have to go upstairs, and take them up with you when you go up to bed.
- Do your shopping when stores are less busy, and use a basket on wheels so you don't have to carry heavy items.
- Think about your sleeping patterns – getting enough sleep can help reduce fatigue.
- Sleep for just as long as it takes to feel refreshed.
- Get your body into a routine, by going to bed and getting up at the same time every day.
- Try to reduce noise in your bedroom.
- Keep a steady temperature in your bedroom.
- Have a bedtime snack, to avoid waking up hungry during the night.
- Avoid stimulants like coffee, tea, chocolate and cola drinks during the evening.
- Limit your intake of alcohol.
- Know how naps affect you – for example, if you sleep in the afternoon, will it keep you from sleeping at night?
- Use relaxation techniques to help you get to sleep.
Myeloma and its treatments, such as chemotherapy (which can reduce your white blood cell count), can affect your body's ability to fight off infections, leaving you more susceptible to them.
There are things you can do to help reduce your chance of getting infections – which 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 a cold, the flu or other infections, such as measles, chickenpox and shingles.
- Make sure the food you eat is as fresh as possible, that fruits and vegetables are carefully washed, and that meat is well cooked, to avoid picking up a "stomach bug."
Be on the lookout for signs of infection, such as:
- Cough or sore throat.
- Feeling generally unwell or feverish.
- Pain, redness or swelling around a cut or wound, or around the entry port of your HICKMAN® catheter or Port-a-Cath, if you have one.
- Temperature above 38ºC.
Let your doctor know if you think you may have an infection. A course of antibiotics from your family physician may resolve the infection. However, if the infection persists, you may need to go to the hospital to receive antibiotics intravenously.
Protecting your kidneys
There are a number of ways myeloma can affect your kidneys. Kidney problems can be caused by the myeloma itself and/or by the drugs used to treat it.
Drinking at least two litres of water each day is a good way to help protect your kidneys. If you find that difficult to do, try to drink small quantities of water at frequent intervals throughout the day, so it becomes a habit.
You should also avoid taking very large doses of vitamin C (i.e., more than 500 mg per day) that add acidity to your urine, and could potentially damage your kidneys.