Dealing with pain and mind/memory problems - Myeloma UK · Dealing with pain and mind/memory...
Transcript of Dealing with pain and mind/memory problems - Myeloma UK · Dealing with pain and mind/memory...
![Page 1: Dealing with pain and mind/memory problems - Myeloma UK · Dealing with pain and mind/memory problems Lisa Ferguson ... Chemo brain. Steroids can cause some troublesome ‘neuropsychiatric’](https://reader033.fdocuments.us/reader033/viewer/2022042313/5edbf532ad6a402d66666a39/html5/thumbnails/1.jpg)
Dealing with pain and mind/memory problems
Lisa Ferguson
Myeloma Advanced Nurse Practitioner
Oxford University Hospitals NHS Trust
![Page 2: Dealing with pain and mind/memory problems - Myeloma UK · Dealing with pain and mind/memory problems Lisa Ferguson ... Chemo brain. Steroids can cause some troublesome ‘neuropsychiatric’](https://reader033.fdocuments.us/reader033/viewer/2022042313/5edbf532ad6a402d66666a39/html5/thumbnails/2.jpg)
This talk will cover…
Two complications of myeloma and/or
side-effects of its treatment:
• Pain
• Mind and memory problems
How these can be treated and managed
![Page 3: Dealing with pain and mind/memory problems - Myeloma UK · Dealing with pain and mind/memory problems Lisa Ferguson ... Chemo brain. Steroids can cause some troublesome ‘neuropsychiatric’](https://reader033.fdocuments.us/reader033/viewer/2022042313/5edbf532ad6a402d66666a39/html5/thumbnails/3.jpg)
1. Myeloma and its treatments can cause a number of
complications and side-effects
2. Be aware of these, look out for them and report
them to your doctor or nurse
3. They can sometimes be prevented, and can be
managed and treated so that they have less of an
impact on quality of life
Three take home messages
![Page 4: Dealing with pain and mind/memory problems - Myeloma UK · Dealing with pain and mind/memory problems Lisa Ferguson ... Chemo brain. Steroids can cause some troublesome ‘neuropsychiatric’](https://reader033.fdocuments.us/reader033/viewer/2022042313/5edbf532ad6a402d66666a39/html5/thumbnails/4.jpg)
Side-effects and complications
![Page 5: Dealing with pain and mind/memory problems - Myeloma UK · Dealing with pain and mind/memory problems Lisa Ferguson ... Chemo brain. Steroids can cause some troublesome ‘neuropsychiatric’](https://reader033.fdocuments.us/reader033/viewer/2022042313/5edbf532ad6a402d66666a39/html5/thumbnails/5.jpg)
“A constant daily
grind. Limiting
me physically at
work and in
social terms. You
learn to cope but
it’s hard for other
people to really
understand what
you feel.”
Vote:
Q: Has myeloma-
related pain
affected you?
Pain
![Page 6: Dealing with pain and mind/memory problems - Myeloma UK · Dealing with pain and mind/memory problems Lisa Ferguson ... Chemo brain. Steroids can cause some troublesome ‘neuropsychiatric’](https://reader033.fdocuments.us/reader033/viewer/2022042313/5edbf532ad6a402d66666a39/html5/thumbnails/6.jpg)
Top 5 causes of pain in myeloma
![Page 7: Dealing with pain and mind/memory problems - Myeloma UK · Dealing with pain and mind/memory problems Lisa Ferguson ... Chemo brain. Steroids can cause some troublesome ‘neuropsychiatric’](https://reader033.fdocuments.us/reader033/viewer/2022042313/5edbf532ad6a402d66666a39/html5/thumbnails/7.jpg)
Pain affects up to 80% of patients at some
point during the course of their myeloma.
Results from a
2017 Myeloma UK
patient survey
“My pain is constant and
unrelenting – it gives a feeling
of isolation that no one apart
from me and my husband can
understand. It’s a daily battle
to keep focused”
100%physical effects
60%
55%
social effects
psychological &
emotional effects
100%
How pain can affect you
![Page 8: Dealing with pain and mind/memory problems - Myeloma UK · Dealing with pain and mind/memory problems Lisa Ferguson ... Chemo brain. Steroids can cause some troublesome ‘neuropsychiatric’](https://reader033.fdocuments.us/reader033/viewer/2022042313/5edbf532ad6a402d66666a39/html5/thumbnails/8.jpg)
Pain management
![Page 9: Dealing with pain and mind/memory problems - Myeloma UK · Dealing with pain and mind/memory problems Lisa Ferguson ... Chemo brain. Steroids can cause some troublesome ‘neuropsychiatric’](https://reader033.fdocuments.us/reader033/viewer/2022042313/5edbf532ad6a402d66666a39/html5/thumbnails/9.jpg)
Non-medical treatment
![Page 10: Dealing with pain and mind/memory problems - Myeloma UK · Dealing with pain and mind/memory problems Lisa Ferguson ... Chemo brain. Steroids can cause some troublesome ‘neuropsychiatric’](https://reader033.fdocuments.us/reader033/viewer/2022042313/5edbf532ad6a402d66666a39/html5/thumbnails/10.jpg)
“Take each day as it comes
because every day is different.
Feeling positive helps!”
Living with pain
![Page 11: Dealing with pain and mind/memory problems - Myeloma UK · Dealing with pain and mind/memory problems Lisa Ferguson ... Chemo brain. Steroids can cause some troublesome ‘neuropsychiatric’](https://reader033.fdocuments.us/reader033/viewer/2022042313/5edbf532ad6a402d66666a39/html5/thumbnails/11.jpg)
“Seek support from as
many places as
possible. Hospice
outpatient teams can be
very helpful and also
open up opportunities
for complementary
therapies”.
“Get a really
comfortable
mattress if you are
suffering back and
rib pain.”
Tips from 2017 survey of patients about pain
“Try orthotic
insoles to relieve
peripheral
neuropathy.”
Patient tips
![Page 12: Dealing with pain and mind/memory problems - Myeloma UK · Dealing with pain and mind/memory problems Lisa Ferguson ... Chemo brain. Steroids can cause some troublesome ‘neuropsychiatric’](https://reader033.fdocuments.us/reader033/viewer/2022042313/5edbf532ad6a402d66666a39/html5/thumbnails/12.jpg)
Vote:
Q: Have you
been affected
by mind or
memory
problems?
Mind/memory problems
![Page 13: Dealing with pain and mind/memory problems - Myeloma UK · Dealing with pain and mind/memory problems Lisa Ferguson ... Chemo brain. Steroids can cause some troublesome ‘neuropsychiatric’](https://reader033.fdocuments.us/reader033/viewer/2022042313/5edbf532ad6a402d66666a39/html5/thumbnails/13.jpg)
• A general fogginess,
feeling out of sorts,
struggling to remember
words - usually due to
the effects of treatment
• Fatigue, infection,
stress and anxiety can
make things worse
Chemo brain
![Page 14: Dealing with pain and mind/memory problems - Myeloma UK · Dealing with pain and mind/memory problems Lisa Ferguson ... Chemo brain. Steroids can cause some troublesome ‘neuropsychiatric’](https://reader033.fdocuments.us/reader033/viewer/2022042313/5edbf532ad6a402d66666a39/html5/thumbnails/14.jpg)
Steroids can cause
some troublesome
‘neuropsychiatric’
side-effects
• irritability
• psychosis
• mania
• euphoria
• agitation
• panic
• mood
swings
• anxiety
• insomnia
• depression
• distractibility
• delirium
• memory
loss
The dreaded dex
![Page 15: Dealing with pain and mind/memory problems - Myeloma UK · Dealing with pain and mind/memory problems Lisa Ferguson ... Chemo brain. Steroids can cause some troublesome ‘neuropsychiatric’](https://reader033.fdocuments.us/reader033/viewer/2022042313/5edbf532ad6a402d66666a39/html5/thumbnails/15.jpg)
• Report dex side-effects promptly to
doctor or nurse – doses can be
lowered and/or frequency adjusted
• Try relaxation, meditation or
visualisation techniques
• Take dex in the morning to reduce
insomnia
Managing dex
![Page 16: Dealing with pain and mind/memory problems - Myeloma UK · Dealing with pain and mind/memory problems Lisa Ferguson ... Chemo brain. Steroids can cause some troublesome ‘neuropsychiatric’](https://reader033.fdocuments.us/reader033/viewer/2022042313/5edbf532ad6a402d66666a39/html5/thumbnails/16.jpg)
• Write important details down - use post-its, a
notepad or noticeboard
• Put everything in a diary or wall calendar
• Set alarms and reminders on your phone
• Take gentle exercise
• Do mental exercises like puzzles and crosswords
• Take time in the evening to reflect and process the
day
• Rest well
Mind/memory problems
– self help
![Page 17: Dealing with pain and mind/memory problems - Myeloma UK · Dealing with pain and mind/memory problems Lisa Ferguson ... Chemo brain. Steroids can cause some troublesome ‘neuropsychiatric’](https://reader033.fdocuments.us/reader033/viewer/2022042313/5edbf532ad6a402d66666a39/html5/thumbnails/17.jpg)
“I decided the best plan
was to stop apologising
for my unusual
behaviour, move on and
understand it was just
part of the reaction to
the drugs.”
“Try to prepare for your
‘dex days’. Take a long
walk to tire yourself out,
have a paper to read or
a programme to watch is
you wake and can’t get
back to sleep.”
Tips from patients featured in Myeloma
Matters.
Patient tips
![Page 18: Dealing with pain and mind/memory problems - Myeloma UK · Dealing with pain and mind/memory problems Lisa Ferguson ... Chemo brain. Steroids can cause some troublesome ‘neuropsychiatric’](https://reader033.fdocuments.us/reader033/viewer/2022042313/5edbf532ad6a402d66666a39/html5/thumbnails/18.jpg)
• Pain
• Mind and memory problems
• How these can be treated and managed
Please ask any questions about other complications
and side-effects in this afternoon’s
‘Ask the Expert’ session
This talk has covered…
![Page 19: Dealing with pain and mind/memory problems - Myeloma UK · Dealing with pain and mind/memory problems Lisa Ferguson ... Chemo brain. Steroids can cause some troublesome ‘neuropsychiatric’](https://reader033.fdocuments.us/reader033/viewer/2022042313/5edbf532ad6a402d66666a39/html5/thumbnails/19.jpg)
“Don’t waste time and
energy on things you can’t
do anymore. There are still
lots of things you can do.”
Tips from The small things that make all
the difference book
Patient hints and tips
![Page 20: Dealing with pain and mind/memory problems - Myeloma UK · Dealing with pain and mind/memory problems Lisa Ferguson ... Chemo brain. Steroids can cause some troublesome ‘neuropsychiatric’](https://reader033.fdocuments.us/reader033/viewer/2022042313/5edbf532ad6a402d66666a39/html5/thumbnails/20.jpg)
1. Myeloma and its treatments can cause a number of
complications and side-effects
2. Be aware of these, look out for them and report
them to your doctor or nurse
3. They can sometimes be prevented, and can be
managed and treated so that they have less of an
impact on quality of life
Three take home messages
![Page 21: Dealing with pain and mind/memory problems - Myeloma UK · Dealing with pain and mind/memory problems Lisa Ferguson ... Chemo brain. Steroids can cause some troublesome ‘neuropsychiatric’](https://reader033.fdocuments.us/reader033/viewer/2022042313/5edbf532ad6a402d66666a39/html5/thumbnails/21.jpg)
Myeloma & Me video
‘Roger’s Story - Dealing
with pain’
Myeloma UK resources
![Page 22: Dealing with pain and mind/memory problems - Myeloma UK · Dealing with pain and mind/memory problems Lisa Ferguson ... Chemo brain. Steroids can cause some troublesome ‘neuropsychiatric’](https://reader033.fdocuments.us/reader033/viewer/2022042313/5edbf532ad6a402d66666a39/html5/thumbnails/22.jpg)
Any questions?
Thank you
![Page 23: Dealing with pain and mind/memory problems - Myeloma UK · Dealing with pain and mind/memory problems Lisa Ferguson ... Chemo brain. Steroids can cause some troublesome ‘neuropsychiatric’](https://reader033.fdocuments.us/reader033/viewer/2022042313/5edbf532ad6a402d66666a39/html5/thumbnails/23.jpg)