Trust me I’m a Cancer Patient

trust-me-im-a-cancer-patientTrust Me I’m a Doctor Cancer Patient by Wesley Finegan is a detailed manual for understandings symptoms of cancer, and it’s various treatments and side effects. Finegan worked for a number of years as a doctor with an interest in patients with cancer, before being appointed as a consultant in palliative medicine. Three years later, he became a cancer patient himself. People suggested that he would know all about this, but he had never been a patient before and he still had much to learn. He shares his wisdom in this book. This is the predecessor to his similarly structured book, Being a Cancer Patient’s Carer: A Guide. This book contains forty five chapters and each one follows the same practical structure (TANDEM):

The doctor says
Think
Ask
Note
Do
Explore
More information (pages viii-ix)

The first section of the book is focused on understanding Pain. It discusses the different ways that pain can be assessed, including the classic: ‘What number between 0 and 10 would you give your pain, with 0 being none at all and 10 being the most you could ever imagine?’ I remember being asked this so many times in hospital and usually finding it difficult to differentiate in the 3-7 range. However, there was one occasion when they ripped out my chest drain, that I understood what a 10 felt like!

Good assessment of pain is necessary for good management of pain. In many cases there are a range of pain management options available, so it is important to tune it to its effectiveness, side effects and so on. There has to be teamwork between the patient and doctors to get this right. Others not involved in your health care should not be allowed to interfere or change treatment, as this could be very dangerous. Pain killers need to be very carefully managed. Sometimes there are different means of administering the pain medication. The patient may be able to wear a patch, or be attached to a machine that limits the dose while they self-administer.

The second section of the book documents a long list of Physical Problems that may be associated with the disease or treatments. The list includes: loss of appetite; constipation; depression; diarrhoea; itchiness; sore mouth; difficulty sleeping; constant tiredness; weakness; and many more issues. I can identify personally with all these above. In my case, they are some of the side effects of the chemo, rather than symptoms of the cancer.

The beauty of this book is that you can look up whatever chapters may be relevant at different times. There may be times when I’d look up a number at once, and others that probably wouldn’t get a look in. Many of the chapters contain helpful diagnostic check lists to help you understand what is or isn’t happening to you. You are also encouraged to document pain and symptoms so that you can refer back when things reoccur. This help to recognise patterns, changes, and sometimes alleviate fears when things can be demonstrated to have minimal or temporary impact.

Section three focuses on Personal, Social and Spiritual Problems. Some of these chapters are unlikely to be read in advance by a patient. For example: I am expecting Bad News. You’d have to be very quick off the mark, getting onto this book! However, others offer great advice for further down the track. They deal with some pretty heavy issues, from early ones, such as How to tell my Children the Bad News down the track to I want to make a Will or Euthanasia, living wills (advance directives) and resuscitation.

It’s probably not wise or helpful for people in early stages of cancer to dwell on some of the final chapters. There’s no point and it’s probably not helpful to be rushing into thinking about worst case scenarios. But there will be other chapters in this section worth dipping into early on. Two that have been particularly relevant to me have dealt with thinking through complementary therapies, such as acupuncture, and a chapter on issues relating to returning to work. The 3rd last chapter deals with thinking about spiritual needs. Personally, I wouldn’t leave this until the end, especially in case the end comes earlier than anticipated.

This book would provide an excellent resource for medical students, doctors, nurses and other health professionals engaging with cancer. I’d also recommend families who have someone going through cancer, to get hold of a copy, as a reference book for all to read as relevant.

Being a cancer patient’s carer: A guide

carerguideCancer is tough for the patient, but it’s also tough for those who care for them. It brings so many changes and challenges, and the carer is often as unprepared as the patient. Where does the carer go for help? Many hospitals have cancer support groups, open to both patients and their carers. There are numerous websites such as inspire.com and cancergrace.org that provide information, experience and support to patients and carers. You could contact your local cancer council or other cancer support organisation for help in finding support for carers. And you will find a wealth of informed practical wisdom in Being a Cancer Patient’s Carer: A Guide by Wesley Finegan.

Every person struggling with cancer relies on having carers. These people may be professionals such as specialists, nurses, and pain managers. They may also be personal friends or relatives, often a spouse or an adult child. A competent and compassionate carer is a great blessing. I am especially blessed to have a loving wife, who keeps herself well informed about the disease, treatments, possibilities, alternatives, and more. But then, not everyone with cancer is married to a doctor ;).

Finegan’s book won’t necessarily make someone compassionate, but it will go a long way to making someone competent as a carer. It’s hard to think of an author with greater credentials to write on the topic. He has MB BCh BAO MRCGP MICGP D Pal Med’ listed after his name! I’m not sure what they all refer to, but they sound impressive. More impressive again, is his experience. He worked in General Practice with a special interest in caring for patients with cancer. This led him to become a consultant in palliative medicine. In 1994 he became a cancer patient himself and in 2003 his wife developed cancer and he became her carer. These experiences have taught Finegan much and he generously shares his wisdom in this book.

This guide is intended for practical use. It’s well constructed and easy to follow. Each chapter – and there are 43 chapters, each roughly 4 pages long – is constructed around the acronym TANDEM. They begin with some basic facts to help people understand the particular problem being addressed and then the acronym is used to examine various issues from different perspectives:

T Think
You are facing new situations regularly as a carer. Hopefully I can help you think through the issues you might have to face.

A Ask
There is so much to learn. Where does one start? What do you need to know and who can tell you the answers? I’ll try and help you with some of the questions I have asked.

N Note
Making a note of a relevant detail now might save you a lot of difficulty remembering those elusive facts in a weeks’ time!

D Do
Here I will offer you some practical ideas that have been tried and tested by my patients and some that worked for Alice and me.

E Explore
Sometimes we want to know more or find out about something we would like to know about. I’ll try and guide you to the best sources of information.

M More information
If there is something that has not been said already and it’s relevant, you’ll find it here. (pages x-xi)

I’m not aware of any other books for carers that are as comprehensive and practical as this one. It begins with the first shock of diagnosis, then addresses a broad range of symptom, treatment, and care issues, before dealing with the difficult matters of failed treatment, dying, death and bereavement. It’s concerned for the well-being of the carer as well as the patient.

It’s probably too much to take in all at once, but the beauty of this book is that it’s so well arranged that you don’t have to. You can read whatever’s most relevant to you and your situation at the time. You’ll find it easy to come back to sections you’ve skipped over, if and when they become relevant. And you can follow the links and suggestions for more information or advice when needed. I would suggest consulting it regularly as different issues arise. Flick through the table of contents so you can see the scope of the book. It would also be useful to annotate the book with your own questions and observations, so that you can follow things up with the relevant people at another time.

If you are caring for someone who is going through cancer, then I highly recommend you get yourself a copy of this book. If you have cancer and want to support your carer, then you could purchase a copy for them. It’s readily available on line so you don’t need to worry about what bookshop to look in. You’ll appreciate it and so will they. Just let them know when you give it to them, that they’re doing a great job and you wanted to show your appreciation by giving them this book!