[earle58]

I recently found out that a nurse I work with has breast ca with mets to the nodes. She's an immensely private person (she's our ADON); had a partial mastectomy and will be having radiation and chemo. A couple of us want to do some cooking, cleaning, whatever she may need. My question being what foods would she be more receptive to while she's going through chemo. I don't want to make her even sicker to her stomach. Also, any suggestions on what we could do for her while she goes through this. I'm writing under this specialty knowing that hospice nurses are also very holistic...please advise.

[505rn]

First off, I would like to say that with staff and friends like you, your ADON is very lucky as support/caring, assistance and prayers can do A LOT for an ill person!!! Good for you!!!

Depending upon the type of person your ADON is, some inspirational books, pictures or a calendar might help (I bet they have a Chicken Soup for the Soul book that would be appropriate-you can check their website), telling her in a card or note that she can refer to during the tough times that you all care and, if appropriate for her, are praying for her is nice. Cleaning while she is gone (so as to not embarass her or make her feel weak, lazy or helpless) with not very fragrant cleaner is nice. As are fresh, soft sheets, blanket, robe or "lounging pj's" (so she feels comfortable without feeling like an invalid)...Music can be comforting and uplifting as can flowers. But never forget about humor- that goes a long way too, if you find jokes that she will enjoy, even some about chemo or cancer so she can laugh at it rather than be afraid of it might be helpful- depending upon her personality. Pretty scarves or hats (or funny ones) if she looses her hair. As for food, small amounts of basic things that are not real fragrant and crackers!
I don't know if any of these things will help but I hope so...

My only other suggestion (and I hope that I am not upsetting you too much, but one never knows what might happen and it is not nice to have regrets after someone you care about is already gone...) is that IF she finds out she cannot beat the cancer-be open and talk about it with her (if she wants), help her say good byes, make a dream come true etc. There are some really good books out there about helping someone who is going thru this stage/process of life ( as death is a part of life) and it is an honor to be able to help someone you care about to make that a relatively peaceful process.

[Nora]

With friends like you who care she is in for an easier ride than if she was going it alone. Remember, this is her journey and let her lead you through it with as much independence as she can. Give her choices frequently with foods...appetite and appeals in foods can change as frequently as the weather. What is a favorite one day will bring upon nausea the next. The body responds terribly at times to chemo and radiation and the appetitite is the first to suffer. If it is a big bowl of ice cream with hot fudge and a cherry she wants for dinner, that is what she gets. Dietary restrictions should be thrown away. More important than food, prepare her for her journey with love, acceptance and your always available presence when she hits a low and needs to talk (or at times to vent). She will be angry at you, angry at how bright the lights, how lousy the food you cooked her is....but what she is really angry about is that she cannot control what is going on inside her, so she tries darn hard to control what is going on around her. Good luck.

[Doc]

Earle, this is too broad a topic to cover in a post, so I will just give you a few food pointers and other things.

Depending on the chemo she's been receiving, your ADON may respond better to some foods than others. As a general rule, though, foods that are not spicy or strong smelling and are served cool will be less likely to cause nausea. Many people on chemo can't STAND the smell of hot food! A burning sensation all over the body (and particularly in abdomen and limbs) is commonly felt and this is another reason to serve cool foods. Fresh, refrigerated fruit are generally well tolerated and iceblocks can help stimulate the appetite. The most severe SE of chemo is a harsh burning sensation which is described by patients as not really being pain, but something else which is hard to describe in any other terms but which can drive people absolutely nuts if it persists for more than a couple of hours (and it totally kills the appetite). There are a few causes for this, including damage to the intestinal lining by the chemo agents, and anxiety (some of which is due to the neurological effects of chemo), but a very common cause is peripheral neuropathy (which can be mild, for instance, some tingling of the feet). The burning is part of a syndrome of dysaesthesia. This can be caused by a deficiency in pyridoxine (vitamin B6), of which whole grains, soy beans, organ meats, wheat germ and peanuts are a good source. Tricyclic antidepressants, typically amitriptyline 10mg, interestingly have great results for burning dysaesthesia! Dexamethasone is also used for the peripheral neuropathy (and as long as it is tolerated, is usually also effective in treating the burning sensations), but I'm sure you know the side effects and potential risks. One major side effect of dexamethasone is being kept awake at night.

Many still believe that antioxidants are still beneficial at this stage, so again the wheatgerm! Basically anything with vitamins A, C and E and the bio/isoflavinoid groups (tea, purple grape juice and very small amounts of dark chocolate, for instance). Anything immune-boosting is beneficial, and needless to say, all the infection control measures (staying away from major crowds, good handwashing, keeping a distance from any pets, etc) is a good idea, and if WBCs start getting really low, she should definitely stay at home. If she has not already received a flu vaccination, now is the time.

You seem a very supportive group of nurses. Your ADON is very lucky to have such caring people. I wish you, your colleagues and your ADON the best of luck in the future.


[This message has been edited by bshort (edited March 14, 2001).]

[bonde0613]

It is nice to hear about such wonderful, supportive friends. I worked for a Cancer Institute for a couple of years, and found that support and encouragement from friends, family and coworkers was one of the most important aspects of a patient's recovery.

A couple of suggestions I have: The American Cancer Society has wonderful booklets for eating while undergoing Radiation and Chemotherapy. They have specific recipes that are very helpful.

Dr. Susan Love has a terrific book out (Dr. Susan Love's breast book) that is VERY comprehensive. (Not recommended for the very anxious patient - too much information can do more harm than good). This will help your friend with lab results, doctor visits, and general questions.

Some people may recommend to you the "Dr. Atkins Breast Cancer Diet". Please read this book with caution before you go further....

Your friend will go through very normal emotional stages. We had a "healing coach" at our cancer institute that is starting a national campaign to have more healing coaches around the nation. She was wonderful with the patients. There are so many issues with cancer, and it helps to see a counselor who specializes in these issues and stages.

Finally - some little things that I think seem to "help" -
1) Rides to appointments - it is so helpful to have a friend/second pair of ears to listen to the doctor's and nurse's information
2) Massage - by someone who knows about cancer pain
3) Reflexology has shown wonderful results with Cancer patients
4) Take care of yourself and the other caretakers around your friend.

Hope this is helpful.... I think it's wonderful you're ready to help.