Patient Care and Health Information

As chemo-drugs are mainly designed to kill cells with capacities of rapid dividing, i.e., cancer cells. However, stem cells residing in normal tissues/organs also divide quickly, so they will be affected or even killed by the chemo-drugs too. It therefore understandable that chemo-drugs will induce side effects by destroying stem cells that normally reside in tissues/organs, while they kill cancer cells. For example, the damage of resident stem cells at the gastrointestinal tract will cause nausea, vomiting and loss of appetite. In addition, the metabolites of certain chemo-drugs will also inhibit the feeding center of the brain and reduce to appetite. To alleviate or improve the symptoms, it is recommended to follow the instructions below:

1. Avoid eating at 1 hour before and also 2 hours after chemotherapy if you have experienced nausea or vomiting from previous cycles of treatment. In addition, if you feel nauseated after waking up in the morning, you may want to eat dry foods (such as cereals, bread, or toast) before getting out of bed for more comfort.

2. Eat slowly and eat smaller, more frequent meals, and take high-calorie foods when you have a good appetite. Avoid gas-producing foods or drinking too much liquid to reduce the feeling of fullness.

3. Keep a light diet and avoid foods and beverages that may be over-sweet or greasy (such as candy, cakes, fried chicken, soda, etc.).

4. Chew carefully and swallow slowly. Take your time to allow foods to be well digested.
   

5. Have moderate exercise 5-10 minutes before meals to stimulate appetite. Try not to lie down on your back at 2 hours post meals, and try to take deep breaths or slow down your breathing rate if feeling nauseous.

6. Have some acidic foods or seasonings (e.g., lemon, kiwi, citrus, plum juice, or black vinegar) to reduce nausea and vomiting, and also promote appetite.

7. Take antiemetics as prescribed by your doctor.

8. Enhance oral care to reduce odor and promote appetite. Dine with family or friends can promote motivation to eat.

9. Let the patients choose their foods and change the menu frequently.
   

Why does chemo cause side effects ?

Cancer cells tend to grow fast, and chemo drugs kill fast-growing cells. But because these drugs travel throughout the body, they can affect normal, healthy cells that are fast-growing, too. 

Damage to healthy cells causes side effects. Side effects are not always as bad as you might expect, but it's normal to worry about this part of cancer treatment.

Tips for coping with side effects :

1.Appetite change, nausea or vomiting：

(1)Try to eat smaller meals often instead of 3 larger meals each day and eat what you like. 

(2)Avoid strong-smelling foods, sweets, and fried and fatty foods, which may make you queasy.

(3)Relaxation techniques like deep breathing and meditation may also help relieve nausea and vomiting. After vomiting, you should watch your mouth with water to keep oral hygiene and prevent bad breath.

(4)Or fasting during chemotherapy may have higher tolerance to the treatment. 

(5)Chew your food well and sit upright for 2 hours after eating. This can help with digestion. 

2. Constipation or diarrhoea

(1) Constipation：Eat more high-fibre foods, such as wholegrain bread and pasta, bran, fruits and vegetables, nuts and legumes (e.g. baked beans or lentils). 

Drink plenty of fluids, do some light exercise. If you have tried the above lifestyle changes and still experience constipation, your doctor may prescribe laxatives. 

(2) Diarrhea：Avoid fatty or fried foods, spicy foods, milk and dairy products to minimize chemotherapy-Induced diarrhea. If you have tried the above lifestyle changes and still 

experience diarrhea, your doctor may prescribe antidiarrheal medicines.  

3. Low blood cell counts

(1) Low red blood cell count: You may benefit from adding iron-rich foods to the diet, such as leafy vegetables, lean meat, nuts and seeds.

(2) Low white blood cell count：You should wash frequently your hands with soap and water, maintain social distancing and avoid close contact with people whom are unwell, wear a mask if you are going to crowded places.

(3) Low platelet cell count：It can cause bleeding from the nose, gums or mouth or tiny red spots on the skin, or petechiae or blood in the stool. You should use a toothbrush with soft bristles to avoid irritating your gums and an electric razor when shaving to reduce the chance of nicking yourself.

4. Mouth ulcers

(1) Use a soft toothbrush to clean your teeth twice a day, rinse your mouth with warm water or mouthwashes without alcohol after eating. 

(2) Eat properly and choose foods that are easy to chew. Have meal with high calorie and reach protein, avoid acidic or spicy food, such as tomamto, lemon or coarse foods. These can all aggravate mouth sores.

5. Hair Loss

Wear a wig, hat or turban. Use a mild shampoo and comb or brush your hair gently using a large comb or a hairbrush with soft bristles. 

When to seek medical help

1.A temperature of 38°C or higher

2.Vomiting that lasts more than a few hour

3.Severe abdominal pain, constipation or diarrhea

4.Unusual bleeding or bruising, such as nosebleeds, blood in your urine or black bowel motions

5.Burning or stinging feeling when urinating

★ artificial blood vessel care instructions

 1. It is still necessary to observe the daily application of artificial blood vessels (arterial catheter) to the surrounding skin (wound) for pain, redness,
     secretion. If signs of infection, fever, etc. occur, be sure to return to the hospital for a visit.
 2. After the wound is healed, you may shower without changing the medicine.
 3. When using artificial blood vessels for medical treatment, the exclusive safety injection needle is inserted into the injection seat.The process is
     similar to a general intravenous injection and has a slight stinging sensation. After the injection of the curved needle, saline + heparin (flushing) is
     used to ensure that the pipeline is smooth before drug injection.
 4. The nursing staff will change the injection bender every 7 days, assist in changing the dressing and observing the injection site.
 5. Daily activities are not affected, but to avoid catheter displacement, the device should be placed on the same side of the arm.Excessive activities,
     such as 360-degree rotation, intense chest movement, intense swimming, lifting heavy weights, weightlifting, golfing and others can cause
     collisions and put pressure on the artificial blood vessels.
 6. In order to avoid the obstruction of the artificial blood vessel lines, medical staff will use saline + anticoagulants each time you return to the clinic to
     flush the artificial blood vessels.
 7. Pay attention to the skin around the artificial blood vessels. If there is any observed redness, swelling, heat, pain or damaged skin, return to the
     hospital for a checkup.
 8. When the treatment is over, discuss things over with your doctor to make sure you don't have to use artificial blood vessels.The surgical method
     removes the artificial blood vessel.

Precautions before surgery:

• Fasting for at least 8 hours (this includes water and cigarettes).

• If the patient himself is taking hypertensive drugs or anticoagulants, it is necessary to ask the anesthesiologist 
  whether or not medication should be stopped on the day of surgery.

post-operative care and observation focus

• 1. After the operation, the wound in the artificial blood vessel (arterial catheter) will cover the gauze and the pressure of the rubber. If the wound has not been removed, do not touch the water.
  Medicine needs to be changed at least once a day. If there is no moisture or sweat, it should be replaced immediately to keep the wound clean, dry and free from infection.
  2. If you feel any of the following discomforts, you should inform your health care provider as soon as possible

• The wound has problems such as splitting, bleeding, pain, redness, swelling, secretion, chest tightness, chest pain.

• The position of the artificial blood vessel is moved or the injection site is inserted.

It is highly recommended that you click this link to YouTube and watch it in full screen (with Chinese and English subtitles)

https://www.youtube.com/watch?v=9UphcLDPpK4&t=8s