April 26, 2010
To The Patient - Cope, Compromise And Hope
Ernest H. Rosenbaum, MD and Isadora R. Rosenbaum, MA
You, the patient, can help give direction to your desire to rehabilitate yourself in conjunction with the efforts of your health team. Our concept of rehabilitation is one that requires a total approach to the person with cancer -- one that includes the mind, exercise, nutrition, sexuality and supportive care.
Only with the acquisition of specific knowledge can we begin to conceive possible solutions to our complex health problems. To achieve any level of success, you, the patient, must accept responsibility for the role you can play in your medical care. Having made the critical decision that you want to get well, you must believe it worth the effort and be willing to make sacrifices and give sufficient attention to the task,
To cope may frequently require a compromise -- to accept what cannot be changed and then proceed from there. Patients can set new realistic goals. They must leave anger and bitterness behind and free their energies to live in the present.
To live in the present a patient must have hope, because hope is an essential part of the will to live. Hope can come from many sources: from the doctor who shares therapeutic plans with you, the patient; from the family members and friends who seek to help, but primarily, hope will come from you, the patient, who is willing to help yourself.
By knowing yourself, your goals in life, your limits and capacities, and how to compensate for the stresses and trials of daily life, you can accelerate your rehabilitation. Knowing how to keep your cool how to keep your frustration level low and how to appropriately utilize support systems can make the difference between success and failure in treatment. Psychological and spiritual aids can help control the disturbances of external mental pressures.
When you have a disease, there is accompanying chronic feeling of tiredness, often so subtle that it may not be recognized for what it really is. Appropriately expending energy is paramount, lest the tiredness be compounded and characterize daily life. An energy deficient manifests itself in how we feel, emotionally, and physically. It can mean the difference between health or illness, misery or happiness. Fortunately we have ab energy reserve upon which to draw. Energy needs may be constant and predictable, yet vary in the ways they are met. The better our mental and physical state, the greater the vitality and energy reserve. In summary, you should keep in mind the following guidelines:
Your need for sleep will vary and depends, in part, on your activities and habits (not all people require eight hours nightly). Prolonged lack of sleep reduces efficiency and the ability to function. How you sleep is important too. A good night's sleep is as good as gold. If sleeping pills or tranquilizers are helpful in obtaining an adequate night's rest, they should be used. Resolving perplexing and aggravating emotional problems helps immeasurably. The use of relaxing techniques, meditation and biofeedback is often invaluable.
Eating balanced meals, with adequate protein and calories, is vital in helping you to tolerate therapy, to fight disease, and have the strength to return to active life. Fad nutritional notions and diets should be avoided.
An active and organized exercise program -- with appropriate rest periods -- is absolutely essential in maintaining good physical status. Exercise provides a feeling of well-being, reduces stress, aids relaxation, increases reserve strength and promotes better sleep. Gradual levels of exercise that add increasing variations as you improve will avoid fatigue and frustration. Nothing is more reassuring than to see and feel self-improvement. Concurrent use of an occupational therapy program will help accelerate your recovery.
Your sexuality is still a part of your total being when you have a chronic illness and is an area of concern that should not be ignored. If adjustments in your patterns of sexual expression are necessary, often communication may enable you to work these out alone with your partner. For those who need help, counseling is available.
Periods of trained relaxation two to three times a day will help make life more enjoyable. We go through so many changes daily -- from hectic stress periods to diversion and relaxation -- that we need a tool to help us cope with them. Meditation, biofeedback, and other techniques can relax the mind and reduce stress. Outlets such as hobbies, sports and various types of mental or physical games help maintain energy resources. Allot specific times to be good to yourself. These times should be private, personal and inviolate. A cardinal rule is: Don't use your relaxation time as a work period! To do so will only increase mental tension and physical exhaustion.
In short one's life must be restructured if one hopes to succeed in obtaining as full a rehabilitation as possible, no matter what the problem. A person cannot change completely, but altering daily habit patterns, even some of life-long duration, can be adjusted and altered by setting reasonable goals and personal priorities, so that time is used both efficiently and constructively. Self-help and self-support programs are designed to help you formulate a better recovery program to accelerate, complete and maintain your rehabilitation.
The Measure Of Man
It is not the critic who counts, nor the man who points out how the strong man stumbles, or where the doer of deeds could have done better.
The credit belongs to the man who is actually in the arena; whose face is marred by dust and sweat, who strives valiantly; who errs and may fail again, because there is no effort without error or shortcoming.
But who does actually strive to do the deeds; who does know the great enthusiasm, the great devotion, who spends himself in a worthy cause; who at the best, knows in the end of the triumph of high achievement, and at the worst, if he fails, at least falls while daring greatly, so that his place shall never be with those cold and timid souls who know neither victory nor defeat.
-- Theodore Roosevelt
Reprinted by permission