Tips for Managing Eating Problems & Diet after Chemotherapy

Good nutrition for chemotherapy patients can be affected by poor mouth care, fatigue, pain, and fever, as well as the many symptoms that can occur during and after cancer chemotherapy treatments. The goal is to know how to combat these symptoms and maintain an adequate diet after chemo.

Goals for managing symptoms to achieve a good diet after chemo:

Loss of appetite for food (Anorexia):

• Plan ahead-plan a daily menu in advance.
• Make every bite count-chose high calorie and protein foods (casseroles, fortified milkshakes, peanut butter added to snacks).
• Pack snacks to keep on hand at all times.
• Strive to eat at least 1/3 of your calorie and protein needs at breakfast.
• Eat 5-6 small meals per day (this helps to sneak in extra calories and protein).
• Don’t be afraid to try something new, this might spark your appetite.
• Be sure to follow good mouth care practices.

 

Difficulty Swallowing (Dysphagia):

• After chemo treatments, soft foods may improve swallowing problems. These tend to go down easier.
• Consider high calorie and protein milkshakes. Liquids tend to be the best tolerated, especially if the difficulty swallowing is related to a narrowed esophagus.
• Chew solid foods thoroughly.

 

Nausea/Vomiting

Foods to avoid (especially for patient during and after chemo):

• Hot, spicy foods (hot pepper, curry, Cajun Spice Mix)
• Fatty, greasy or fried foods.
• Very sweet, sugary foods.
• Large meals.
• Foods with strong smells (foods that are warm to end to smell stronger).
• Eating or drinking quickly.
• Drinking beverages with meals.
• Lying down after a meal.

 

Diet tips to try:

• Small meals throughout the day.
• Refrigerated or room temperature entrees.
• Rinse mouth with lemon water after eating.
• Suck on ice cubes, mints, or hard candies.
• Distractions such as TV, music, or reading may be helpful while eating.

 

Lifting and Transferring

Poor posture can create problems by destroying the balance of the spine’s natural curves. Strain on muscles adds stress to the spine that may harm the discs. Poor body mechanics upset the balance of the natural curves of the spine. Good body mechanics keep your spine balanced during movement.

Why Exercise?

Exercise relieves stress through activity. Stretching and strengthening exercises combine to balance the strength and tone of the muscles and ligaments. The muscles and ligaments are the supporting structure of the spine, so fitness benefits spinal health.

 

Lifting and Transferring Techniques

Serious back, shoulder, and neck injuries occur as a result of poor lifting and transferring habits. The following are some tips to reduce the strain on your back and the possibility of injuries. Protecting your back is working smarter, not harder.

 

General tips for lifting and transferring include the following:

• When lifting and transferring, the most important consideration is safety for yourself and the patient.
• Ask for help when available and use teamwork. Talk to your helpers about what you plan to do, and talk to each other about what you are doing as you do it.
• When needed, use the right equipment.
• Plan the job. Move anything that is in the path.
• Maintain the correct posture: Keep your back straight and knees bent. If you must bend from the waist, tighten your stomach muscles while bending and lifting. Bending your knees slightly will put the stress on your legs, not your back.
• Never twist when lifting, transferring or reaching. Pick up your feet and pivot your whole body in the direction of the move. Move your torso as one unit. Twisting is one of the leading causes of injuries.
• Maintain a wide base of support. Keep your feet at least shoulder width apart or wider then lifting or moving.
• Hold the person or object close to you, not at arm’s length. Holding things close to your body can minimize the effects of the weight.
• Pushing is easier than pulling, because your own weight adds to the force.
• Use repeated small movements of large objects or people. For example, move a person in sections, by moving the upper trunk first and then the legs. Repeated small movements are easier than lifting things or people as a whole all at once.
• Always face the patient or object you are lifting or moving.
• Always tell a patient what you are planning to do, and find out how he or she prefers to be moved.

 

Take the following steps when transferring from the bed to a wheelchair or bedside chair:

• Plan the job and prepare to lift.
• Place the chair at a slight angle to the side of the bed.
• If using a wheelchair, lock both brakes. Fold up the foot pedals and remove the footrests.
• Stabilize the bed so it will not move.
• Put footwear on the patient.
• Lower the bed so the patient’s feet will reach the floor.
• Move the person to the edge of the bed. First move the upper trunk and then the legs one at a time.
• Place the person’s legs over the side of the bed.
• Place your arms around the person, circling the back in a sort of hug.
• Raise the person to a sitting position on the side of the bed.
• Place a gait belt around the patient’s waist if you so desire (recommended).
• Gradually slide or “walk” the person’s buttocks forward until his feet are flat on the floor. “walk” the buttocks by grasping both legs together under the knees and swinging them gently back and forth as the buttocks move forward.
• Place your feet on both sides of the person’s feet for support. Your feet should be far enough apart to give you a good base of support.
• Have the person lean forward and if possible place his arms around your shoulders. Do not allow his arms around your neck, as this can injure your neck.
• Allow the person to reach for the wheelchair arm.
• Bend your hips and knees while keeping your back straight.
• Place your arms around the person’s waist. If using a gait belt, grasp the belt at the sides of the back with both hands. Do not hold the person under the arms-this can cause injury to the patient.
• Keep the person’s knees stabilized by holding your knees against his.
• Pull up to lift the patient, straightening your knees and hips as you both stand.
• Keep the patient close to your body. Keep your knees and hips slightly bent.
• When the person is high enough to clear the armrest or chair surface, turn by taking small steps. Keep the person’s knees blocked with your own knees.
• When turned, bend your hips and knees to squat, lowering the patient to the seat.
• Replace the footrests. Adjust the height of the foot pedals so the person will be sitting with a 90-degree angle at the hips and knees.
• When transporting a person in a wheelchair, pull it backward up steps or curbs.
• Follow the same principles to return the person to bed.

 

If a person begins to fall, keep the following in mind:

• Once a patient has started to fall, it is almost impossible to stop the fall.
• Instead of trying to stop the fall, try to guide the patient to the floor.
• Once the patient is on the floor, get help to lift him.
• You  might find that someone has slipped to the floor but is not seriously injured. He or she may be able to assist you in getting up. When appropriate, use a mechanical lift or hoist to raise a patient.

 

Take the following steps when transferring in and out of a car:

• Put the front seat of the car as far back as possible.
• Position the wheelchair at a 90-degree angle to the car seat.
• Bend your knees and hips in a squat.
• Place your arms underneath the person’s armpits and around the upper part of their back. He/She may place their arms around your shoulders but not your neck. Grasp the person’s upper back and do not pull under his arms. Hold him close to you.
• Straighten your legs and hip slightly as you smoothly lift the person’s torso into the car, placing his buttocks on the seat. Move your feet to turn, do no twist.
• Be sure his buttocks are as far back toward the driver’s side as possible before lifting his legs into the car. When lifting his legs, keep your back straight.

 

Take the following steps when pulling patient up in a chair:

• Have the patient fold his arms across his chest. Lock the wheelchair brakes.
• Stand behind the patient, bend your knees, and wrap your arms around him, hugging his torso securely by folding your arms just under his in front.
• Straighten your legs, lifting the patient’s torso up and back in the chair.

 

Take the following steps when turning a patient from side to side:

• Stand at one side of the bed, with the bed raised to waist height.
• Place your arms under the patient’s shoulders and hips, or grasp the lift sheet.
• Cross the patient’s leg closet to you over the other leg.
• Place your hands on the patient’s shoulder and hip closest to you.
• Lean in toward the patient and push the patient’s torso away from you.
• Place the top leg in front of the bottom leg.
• Support the patient’s shoulders, back and hips with pillows. Place a pillow between the patient’s legs to support the top leg. Adjust for comfort.

 

Devices that can help you work smarter, not harder, include the following:

• Draw sheets make it easier to pull a person up in bed and move them to the side. To place a draw sheet under a patient, turn the patient on his or her side and lay the draw sheet on the bed. Roll half of the draw sheet up against the patient. Turn the patient to his other side, rolling him over the rolled-up draw sheet, and pull the rolled draw sheet out and straighten it on the bed. The lift sheet should extend from above the shoulders to below the hips and should support the neck and head if the patient cannot do so.
• Bed controls raise or lower the bed to a comfortable and safe position for you and the patient.
• Slide boards help to reduce friction so the patient can slide from the bed to another surface.
• Trapeze over the bed can allow patients to help you move them. They can grasp the trapeze, pull themselves up, and assist as you move them.
• Gait belt is made from heavy canvas with a sturdy buckle. Place the belt around the patient’s waist and use it to assist you in moving him or her.
• Mechanical lifters/hoists can lift a patient who is heavy or one who has fallen. Ask your supervisors for instructions before using these devices.