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Archive for the ‘Depression’ Category

From the Physician’s Desk … Weekly Blog!

Don’t forget to visit … http://www.LegacyEducators.org and click on “Cancer Information”

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Last week we began on the topic of cancer recurrence. Usually, this is covered during workshops or one-on-one counseling sessions. This is an extensive and important topic for survivors.

It is difficult to address the fear of cancer recurrHopeence and give a definitive prescription on how to treat it. Every patient is different, and therefore, their needs in handling the tough topic of a cancer recurring will also be different. In order to individualize a patient’s care, the patient MUST be involved and willing to become their own advocate, though a love one may also be just as helpful.

  1. The Fear of the cancer coming back once treatment is complete, is absolutely normal.
  2. The Fear of cancer recurrence is usually link to one’s outlook on “Death and Dying”, so it is very important to openly discuss your thoughts about this topic (even if it is with yourself…first, to thine own self be true)
  3. Do not compare your treatment process with someone else’s or try to identify with someone else with a similar cancer (someone will always be doing better or and someone will always be worse)
  4. Be honest with yourself. Say out loud what your needs are…and then get it! Need a hug, need to laugh, need to cry, etc., These are normal range of emotions and needs. Don’t be afraid to fulfill them.
  5. Be ready and willing to let go of the fear. This will allow for healing and make the concerns and associated symptoms less traumatic each year. This too, takes time…
  6. Do not be afraid to seek help. Counseling and guidance from a professional, will ease the (perceived) burden of sharing with friends and family continually. It will also allow for venting, and provide personalized strategies on how best to handle anxiety, depression, etc., without repercussions.  Most cancer centers have such services available…please do ask!
  7. Know that your family and friends DO love and care for you. If they become tired, it is not just you. The care and concern for your well being also weighs heavily on them – in addition to work and other life stressors. Not communicating with them or not sharing, will not make their concern go away…it’s all a part of loving and caring for someone else.

hope-life-people-quotes-Favim.com-426177_largeThe Process: The process is rather extensive for this blog. However, I invite you to please take a moment to read and share this link from the American Cancer Society by clicking HEREThey did a great job of tackling different aspect of the fear of cancer recurrence.

Peace and Blessings!

 

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Remember …

Ipsa Scientia Potestas est    ———  Knowledge itself is power!

Don’t forget to visit my website … www.LegacyEducators.org 

Your Family Friendly Doc … Dr McGann!  

See you next week…

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From the Physician’s Desk … Weekly Blog!

Don’t forget to visit … http://www.LegacyEducators.org and click on “Cancer Information”

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A diagnosis of Cancer is a life changing event.

Once treatment is complete, the Fear of the Cancer Coming back (recurring)… is VERY common among cancer survivors…know that you are not alone.

recurrence1Many will attest that cancer diagnosis and treatment is (was) the most difficult thing to deal with.  HOWEVER, once the treatment is completed – surgery, months of chemotherapy, and weeks of radiation therapy, or a combination thereof – it is rather uncommon for a physician to use the other “C” word … Cure, because, the other “C” word would mean the cancer will never come back.

You see…no one can make such a guarantee. Oncologists (cancer doctors) truly does not know and cannot risk giving such a guarantee. Statistics can be given, but that too can be dangerous, as it truly depends on the patient’s personality. If the patients is an optimist (glass half full) then they will always think of being on the positive side of the equation, but if a pessimist (class half empty) then may be more self defeating.

Many patients live in ultimate dread of that post-treatment cancer evaluation/check-up. The mammogram for breast cancer, PSA’s for prostate cancer, colonoscopy for colon cancer, CT scans for lung cancer, the endoscope for head and neck cancer, the pelvic exam for gynecologic cancer, and so on, and so forth can be crippling. Patients often share that their thoughts include questions such as:

  • What if the cancer comes back?
  • What if I must go through those dreadful treatments again?
  • What if it becomes painful?
  • What if it comes back in a different area?
  • What if I ultimately die from this cancer?

New LifeSuch thoughts can be quite burdensome and may lead to heart palpitations, panic and anxiety attacks. These symptoms can occur days (and sometimes weeks/months) leading up to the follow-up appointments. Some patients may resort to living life to the fullest (sky diving, international travels, fulfilling bucket lists, etc.,) while others may abandon living (no plans for the future, no long term savings/retirement, depressed, etc..,). Both responses should be addressed.

While we can definitely do a better job at addressing the individual needs of each survivors… we are lacking the resources and staff. The Oncology community is working very hard to make a change. In the meantime, patients and their family can use an advocacy approach…how can they address their personal fear of cancer recurrence? What can they do to decrease some of the symptoms they are experiencing?

Stay tuned…next week we will review a few strategies to address some of the more common symptoms brought about by the Fear of Cancer Recurrence…

Consider the video below…more next week!

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Remember …

Ipsa Scientia Potestas est    ———  Knowledge itself is power!

Don’t forget to visit my website … www.LegacyEducators.org 

Your Family Friendly Doc … Dr McGann!  

See you next week…

Read Full Post »

From the Physician’s Desk … Weekly Blog!

Don’t forget to visit … http://www.LegacyEducators.org and click on “Cancer Information”

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Survivor – An individual is considered a cancer survivor from the time of diagnosis, through the balance of his or her life. Family members, friends, and caregivers are also impacted.

repairman with the tool on a white background. 3D image

Once cancer treatment is completed, patients transition from regular (daily, weekly, etc.,) healthcare provider’s attention, to follow-up regimen that is once every 3-4 months, twice/year or annually.  This may seem like an “unknown abyss” and some patient may even suffer a form of separation anxiety. What to do?

Patients are encouraged to become their own advocate. That includes, knowing follow-up guideline recommendations for your specific cancer. One size does not fit all! Ask your doctor to give you an idea of the follow-up plan for the next 2-5yrs…yes, you can ask for that. Many organization, including The National Comprehensive Cancer Network (NCCN) provides an update and recommendations annually regarding follow-up.

advocacyWhat does SELF-ADVOCACY mean for a cancer survivor? Well, for starters, here is a list of things you should discuss with your doctor at the end of treatment and during follow-up appointments (not all listed below will apply, but should be tailored to be cancer site specific).

  1. Late Effects/Long-Term Psychosocial and Physical Problems – what should I expect? What symptoms should be reported?
  2. Anthracycline-Induced Cardiac Toxicity – Not all chemotherapy affects the heart, but will the chemotherapy used for me affect me heart 20-30yrs down the road? What can be done to lower the risk?
  3. Anxiety and Depression – What symptoms should be looked for and what signs should be reported?
  4. Cognitive Function – What changes should I expect? Is “chemo-brain” real?
  5. Fatigue – Is it associated with treatment? How long will it last?
  6. Talk with your Oncologist and ask questions!

    Pain – What pain level should be tolerable? Can over-the-counter pain meds suffice? Which ones can be taken?

  7. Sexual Function (female/male) – If viagra does not work, are there other options for ED? What can be used to increase sexual desire in a woman?
  8. Sleep Disorders – how do  know if my sleeping problems are associated with past cancer treatment? Will the treatment be any different?
  9. Preventive Health
  10. Healthy Lifestyles
  11. Physical Activity – What is considered low, moderate and intense activity? Any examples? Are there limitations?
  12. Nutrition and Weight Management
  13. Supplement Use – Any specific type to avoid?
  14. Immunizations and Infections – Any immunization that should be avoided?

Self-advocacy is a lot of work! BUT, it is your life..take charge of it!

 

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Remember …

Ipsa Scientia Potestas est    ———  Knowledge itself is power!

Don’t forget to visit my website … www.LegacyEducators.org 

Your Family Friendly Doc … Dr McGann!  

See you next week…

Read Full Post »

From the Physician’s Desk … Weekly Blog!

Don’t forget to visit … www.LegacyEducators.org and click on “Cancer Information”

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APRIL IS IRRITABLE  BOWEL SYNDROME (IBS) AWARENESS MONTH!

The symptoms of IBS can vary widely from person to person and may even recognize other common disorders/diseases of the gastrointestinal (GI) tract. A “loud/grumbling” stomach, does not mean you have IBS, but it is worth learning more about – just in case!!

IBSAbdominal pain is often described as:

  • Crampy
  • Generalized ache with periods of cramps
  • Sharp, dull, gas-like
  • Modest pains are common
  • Increased gas
  • Altered bowel habits
  • Food intolerance
  • Bloating (distention)

The IBS discomfort or pain usually feels better after a bowel movement.  IBS is a “functional” disorder. Some risk factors for IBS include (but is not limited to): diet low in fiber, excessive use of laxative, longterm use of analgesics (pain medications), etc.,

DO YOU HAVE IBS?  Click  HERE and read page and pdf at bottom left of page.

TREATMENT

  • Though irritable bowel syndrome (IBS) doesn’t have a cure, your doctor can manage the symptoms with a combination of diet, medicines, probiotics, and therapies for mental health problems (anxiety or depression)
  • Traditional drugs include; fiber supplement, anti-diarrheal, anti-flatuents (decrease gas), anti-spasmodic drugs.
  • Eating smaller meals more often, or eating smaller portions, may help your IBS symptoms. You should avoid foods and drinks that make your symptoms worse.

Disclaimer: Use of these videos are for information purposes only and not a form of endorsement.

IBS

For more information please see below

Irritable Bowel Syndrome Awareness Month

International Foundation for Functional Gastrointestinal Disorders
700 W. Virginia Street, #201
Milwaukee, WI 53204
(888) 964-2001
(414) 964-1799
(414) 964-7176 Fax
iffgd@iffgd.org
www.aboutibs.org/site/about-ibs/april-ibs-awareness-month External Links Disclaimer Logo
Materials available
Contact: Nancy Norton

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Remember …

Ipsa Scientia Potestas est    ———  Knowledge itself is power!

Don’t forget to visit my website … www.LegacyEducators.org 

Your Family Friendly Doc … Dr McGann!  

See you next week…

Read Full Post »

From the Physician’s Desk … Weekly Blog!

Don’t forget to visit … www.LegacyEducators.org and click on “Cancer Information”

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THIS IS PRICELESS! PLEASE READ THIS SHORT, QUICK SUICIDE RISK ASSESSMENT GUIDE. Click HERE

suicide_speak_reachAs physicians, we are all about trying to save lives. We want our patients to maintain good cholesterol, manage their diabetes and high blood pressure (or eradicate the need for medication through a life style dietary change and exercise), fight cancer with the weapons we have on hand (surgery, chemotherapy, radiation therapy, etc.,)…life is beautiful…and we fight with our patients to help them live the best lives they can…

Therefore, it always saddens our heart, when a life is lost through a patient’s own hands – SUICIDE. Can we find the needle in the haystack and help these patients before it is too late? An algorithm is being developed to do just that – and the U.S. Army is leading the way. Since 2004, the US Army noted a sharp increase in soldiers’ suicide rate, exceeding that of their civilian counterparts.

JAMA Psychiatry published an article in JAN 2015 titled, “Predicting suicides after psychiatric hospitalization in US Army soldiers: the Army Study To Assess Risk and rEsilience in Servicemembers (Army STARRS).” You may read the abstract HERE  and more about the article HERE  

Take a look around at you – yourself, family, friends, co-workers, colleagues, (including children…especially teenagers) etc., Anyone at risk for suicide? What are the warning signs and why are they important? Take a moment to read the suicide risk assessment guide below.

Say something kind to someone today…give an encouraging word…you never know the difference you may make!

THIS IS PRICELESS! PLEASE READ THIS SHORT, QUICK SUICIDE RISK ASSESSMENT GUIDE. Click HERE or cut and insert this link  https://view.officeapps.live.com/op/view.aspx?src=http%3A%2F%2Fwww.mentalhealth.va.gov%2Fdocs%2FSuicide_Risk_Assessment_Guide.doc

1-800-273-8255 National Suicide Prevention Lifeline (USA)

WARNING SIGNS OF SUICIDE

FACES OF  BEAUTIFUL SOULS (caution, emotionally wrenching…)

RANDOM ACTS OF KINDNESS

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Remember …

Ipsa Scientia Potestas est    ———  Knowledge itself is power!

Don’t forget to visit my website … www.LegacyEducators.org 

Your Family Friendly Doc … Dr McGann!  

See you next week…

Read Full Post »

From the Physician’s Desk … Weekly Blog!

Don’t forget to visit … www.LegacyEducators.org and click on “Cancer Information”

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The U.S. population is always on the go! Things to do, people to see, meeting to attend, business to conduct,  kids recital to attend, kids sporting events, church events….sitting in traffic…falling asleep behind the wheel. Siesta anyone? Fatigue is simply a chronic state of tiredness…being tired…all the TIME!

tired_eyes_800pxAmericans are tired.  It seems to be an “expected” badge of honor  in the National Capital Region (DC, MD, VA). If you are not multi-tasking and dashing to and-fro, complaining about traffic, the weather, politics, or a myriad of other things – something must be wrong with you! OR maybe you are just normal?

Fatigue literally came over me as I wrote the above – because I too, have been caught up in the world wind. I handle stress well and do take at home vacations (stay-cation) and vacations to recuperate, but is that enough? What if we just do not allow ourselves to get so TIRED in the first place? Is that possible? YES!

Fatigue/Tiredness can be manifested as:

  • Difficulty or inability initiating activity (generalized weakness)
  • Reduced capacity maintaining activity (easy fatiguability)
  • Difficulty with concentration, memory, and emotional stability (mental fatigue)

tiredA cross-sectional survey of US workers found that the 2 week period of prevalence of fatigue to be 38%! Additionally, 21-33% of patients seeking attention in the primary care settings report significant fatigue. The statistics for work place injury and motor-vehicle accidents due to fatigue is devastating!

HOW TIRED ARE YOU?? Some disease processes cause/or lead to chronic fatigue. Duration of fatigue can be recent (less than one month), prolonged (more than one month), or chronic (over six months) – talk to your doctor about your state of fatigue.

Fatigue should be distinguished from somnolence, dyspnea, and muscle weakness, although these symptoms may also be associated with fatigue. Patients may use the terms fatigue, tiredness, lack of energy, and excessive sleepiness interchangeably.

TIRED IM SO

PLEASE, GET SOME REST – it is good for YOUR health (and sometimes others too)! See videos below.

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Remember …

Ipsa Scientia Potestas est    ———  Knowledge itself is power!

Don’t forget to visit my website … www.LegacyEducators.org 

Your Family Friendly Doc … Dr McGann!  

See you next week…

Read Full Post »

From the Physician’s Desk … Weekly Blog!

Don’t forget to visit … www.LegacyEducators.org  and click on “Cancer Information”

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Advance DirectiveA difficult conversation is anything you find hard to talk about. It is challenging, because it is surrounded by a cloud of possible conflict, fear, anxiety, anger, depression, or frustration (among other emotions).

But, when having a difficult conversation with yourself, there is no blaming, no misunderstanding, just you and your thoughts. Tough.

Advance directive end-of-lifeFor 2015, I resolve to have a better handle on my finances. Though finance can be a difficult conversation in and of itself, I was caught off guard, when asked if I had a “Living Will and Advance Health Directive”…what? I have asked patients that question on many occasions, but never thought to ask myself. If the patient answered “no” then our wonderful nurse would take care of it and it becomes part of the “cloud”…  doctors are usually not involved.

I am young, healthy, why do I need a Living Will? Hhhmmm. The world is indeed unpredictable and having this information known and written will only serve to help love ones.  Things can happen…suddenly!

Do YOU have an Advance Directive?  

Advance direct dyingA Will Preparation Questionnaire was sent to me. Some of the questions were simple and straight forward, but others were downright brazen and difficult. I am still chewing on:

  • Do you want to be buried or cremated? (depends if natural death or otherwise – hhhmmm)
  • Which of your organs would you like to donate? Hhmmm. (Most organs seem ok…but I flinch whenever I think about my eyes)
  • Do you consent to an autopsy? Or do you leave that decision to your appointed love one/agent? (if foul play suspected, ok with autopsy…otherwise, unsure if necessary), etc.,

Thinking about death may be depressing…but we all know, that death is inevitable. When do you need an Advance Directive? If you are over 18 years old, the experts say you should think about it.

See videos below…think about it?

Life is BEAUTIFUL!

Advance Health Directives

 

Last Will and Testament

 

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Remember …

Ipsa Scientia Potestas est    ———  Knowledge itself is power!

Don’t forget to visit my website … www.LegacyEducators.org 

Your Family Friendly Doc … Dr McGann!  

See you next week…

Read Full Post »

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