The Leukemia & Lymphoma Society




May 22, 2002

Strategies For Energy Conservation


Activity of Daily Living

  • Sit down to bathe and dry off.
  • Use shower/bath organizer to decrease leaning and reaching.
  • Install grab rails in the bathroom.
  • Use extension handles on sponges and brushes.
  • Use elevated toilet seat


Organize Time to Avoid Rushing

  • Lay out cloths and toiletries before dressing.
  • Minimize leaning over to put on clothes and shoes.
  • Bring foot to your knee to apply socks and shoes.  Fasten bra in front then turn to back.
  • Modify the home environment to maximize efficient use of energy.
  • Wear comfortable clothes and low-heeled, slip on shoes.  Wear button front shirts rather than pull-overs.



  • Spread household task throughout the week.
  • Do house work sitting down when possible (i.e.: ironing). Use long-handled dusters, dust mops, etc. Use carpenter’s apron to carry supplies.
  • Delegate heavy housework, shopping, laundry and childcare.
  • Drag or slide objects rather than lifting.  Use leg muscles not your back when working.
  • Stop working before becoming tired.




  • Organize list by aisle.
  • Use grocery cart for support.
  • Shop at less-busy times.
  • Request assistance in getting to the car.
  • Purchase clothing that you do not need to iron.


Meal Preparation

  • Use convenience foods/easy-to-prepare foods.
  • Use small appliance (take less effort to use).
  • Prepare meals sitting down.
  • Arrange preparation environment for easy access to frequently used items.
  • Soak dishes instead of scrubbing, let dishes air-dry.
  • Prepare double portions and freeze half.


Child Care

  • Plan activities to allow for sitting down.
  • Teach children to climb up on the lap or into high chair instead of being lifted.
  • Have children help with household chores.
  • Delegate childcare when possible.



  • Plan workload to take advantage of peak energy times.  Alternate physical with sedatory tasks.
  • Arrange work environment for easy access to commonly used equipment and supplies.



  • Do activities with a companion.
  • Select activities that match energy level.
  • Balance activity and rest.

March 30, 2002

Cancer Fatigue… It’s Real And Should Not Be Ignored
Diane Perez RN MS

Cancer fatigue, often described by patients as a total lack of energy, is the most common side effect of cancer and its treatment, affecting 76 percent of patients undergoing therapy.  Unfortunately, cancer-related fatigue is frequently over-looked, under-recognized and under-treated.

The causes and effects of fatigue are complex, and there is no established method to assess it.  Patients treated by surgery, radiation or chemotherapy experience such side effects as pain, nausea, and fatigue as consequence of the treatment.  Some treatments, the cancer itself or other disorders can also lead to anemia, a frequent cause of fatigue for cancer patients.  The symptoms of cancer fatigue include not only feeling weak-tired, worn out, drained, “wiped out”- but also:

·         Difficulty climbing stairs or walking short distances

·         Shortness of breath after light activity

·         Leg pain

·         Difficulty performing ordinary tasks such as cooking, cleaning, taking a shower or making the bed

Cancer fatigue can have mental and emotional effects as well, including difficulty concentrating- reading or watching television, trouble thinking clearly and making decisions.  Fatigue can underlie patient’s feelings of low self-esteem and frustration, leading to feelings of helplessness or despair.  Changes in sleep, daily activity or eating patterns can cause fatigue, as can anxiety, depression or stress.

Fatigue can significantly interfere with a patient’s quality of life.  For some patients, treating fatigue may be as important as treating the disease.  The known causes of cancer- related fatigue could be treated and possibly relieved, at least to some degree.  To treat the anemia that contributes to fatigue, medication for chemotherapy-related anemia can increase red blood cells, reduce the need for transfusion, and may improve a patients ability to engage in every day activities and cope with the disease. 

*Caregivers need to realize that unrecognized fatigue may be a major factor when patients can’t perform their jobs properly, keep up their daily activities or maintain social contacts

*Lack of understanding within a family about cancer fatigue can lead to communication problems, resentment, and feelings of guilt.


What Can You Do To Manage your Fatigue?

  1. Rest and sleep are important, but don’t overdo it.  Too much rest can decrease your energy level.  In other words, the more you rest, the more tired you will feel.
  2. Stay as active as you can.  Regular exercise like walking several times each week may help.
  3. Drink plenty of liquids.  Eat as well as you can, and eat nutritious foods.
  4. Take frequent rest breaks to save energy got for the things you want to do.
  5. Let others help you with meals, housework, or errands.
  6. Do activities that you enjoy and make you feel good.
  7. Do not force yourself to do more than you can manage.
  8. Keep a diary of how you feel each day to help you plan your daily activities.
  9. Join a support group.
  10. Talk to your nurse or doctor about fatigue, there may be treatment available for your condition.

February 9, 2002


The importance of Pap's smear in the early detection and treatment of cervical has significantly reduced the mortality of cervical cancer . A similar test in the breast called ductal lavage may be useful in the expression of the breast fluid and obtaining breast cells  which may be visualized microscopically and categorized into various subdivisions like atypical hyperplasia, hyperplasia and normal. This study has been able to show that there is a direct correlation between the degree of abnormality and the risk of developing breast cancer. The importance of this is that the information obtained may be used to determine who is at high risk of developing breast cancer. Such determinations allow us to correctly apply the use of Tamoxifen in preventing breast cancer. Is it fair to compare the potential success of this test with the popular Pap Smear?
To read more about this article: Click Here

August 22, 2001


A colostomy is a surgically created opening in the abdomen through which a small portion of the colon is brought up to the surface of the skin.  This new opening, called a Stoma, allows stool to pass directly out of the body, bypassing a diseased or damaged section of the colon.  In some patients, this section may be removed.

After colostomy surgery, your stool will pass through your Stoma, the opening on your abdomen, and empty into a pouch.

Since you will no longer have voluntary control over bowel movements, it is important that you understand the consistency and frequency of discharge unique to your particular type of colostomy within the colon.

Caring for your Stoma

A Stoma (the Greek word for mouth) is shiny, wet and red in color, similar to the inside of your mouth.  It will usually have a round or oval shape, varying in size.  After surgery, the Stoma may appear swollen.  The swelling will go down and it will gradually shrink in size after a few months.  During this time, it is necessary to continue to measure your Stoma, making sure the pouching system fits correctly.

A Stoma does not have nerve endings; therefore, it doesn’t transmit pain or other sensations.  It is, however, rich in blood vessels and may bleed slightly if irritated or rubbed.  This is normal, but if bleeding is prolonged or if discharge from the Stoma is bloody, be sure to contact your doctor.

The skin surrounding the Stoma, called the peristomal skin, must be protected from direct contact with discharge.  This discharge is potentially irritating.  The peristomal skin should be gently cleansed with plain soap that leaves no residue, then rinsed with water during each change of the ostomy pouching system.  It is not necessary to cover the Stoma while bathing or showering, because the water will not enter a stoma; because of its gentle outward contractions.

Remember:  Avoid adhesive buildup.  Adhesive removers can help you wash away adhesive residue easily, without traumatizing sensitive skin.

Cutting the wafer to correct size, correctly applying your pouch, and carefully cleaning and drying the skin around the Stoma with every pouch change are the best ways of preventing skin irritation.  If redness, swelling or a rash persists, call your healthcare professional.

Ostomy Pouching Systems
Pouches today, are made from odor-barrier material, are lightweight and low profile under clothing.  They come in one-piece and two-piece systems.  An ostomy pouching system consists of a special adhesive skin barrier and a drainable or closed-end pouch.

A drainable pouch lets you easily empty the output by releasing a clip and allowing it to drain through an opening at the bottom of the pouch.  A closed-end or disposable pouch is a practical alternative to use during travel or for convenience at any time.    Drainable and close-end pouches are available in both one–piece and two-piece systems.

How often should you change the pouch?

This depends on your type of ostomy, your activities, and the type of pouch you wear.  You may need to change the pouch more often in hot, humid weather.  Avoid changing it daily because this can cause skin stripping and irritation.

Change your pouch on a regular schedule.  This will help prevent skin irritation and leakage.

Special Considerations

If you gain or lose weight, you may need to check the fit of your pouch.

Empty your colostomy pouch when it is half (1/2) full.

Wear your pouch inside your underwear for support.




You should also be aware of the United Ostomy Association, a support group composed of people who have had ostomy surgery.  To find out if your community has a chapter, write or call the UOA at this address:

The United Ostomy Association
19772 MacArthur Blvd.
Suite 200
Irvine, CA 92612-2405
Toll-free number: 1 800-826-0826

Diet Suggestions


      After surgery you can gradually resume eating a balanced diet, unless you are required by your physician to follow a special diet.

      No one diet works the same for everyone.  You may wish to avoid certain foods that cause odor or gas or are hard to digest.  You will quickly discover what foods you may safely eat and those to avoid.

Foods high in fiber, with seeds, or hard to digest should be avoided.  These foods may block the opening of the stoma.

1.  Celery                          4.  Corn

2.  Chinese vegetables       5.  Nuts

3.  Coconut                       6.  Popcorn


Gas Forming Foods

1.  Broccoli                       8.  Fruitcake

2.  Cabbage                      9.  Garlic

3.  Cauliflower                   10.  Green peppers

4.  Chili                             11.  Kale

5.  Cucumbers                   12.  Onions

6.  Dried beans and peas    13.  Sauerkraut

7.  Instant Cocoa               14.  Sweet potatoes


Constipating Foods

1.  Cheese                         5.  Dried fruit

2.  Chocolate                     6.  Fried foods

3.  Wine


Odorous stool

1.  Alcohol                       5.  Eggs

2.  Asparagus                   6.  Fish

3.  Cabbage                      7.  Garlic

4.  Cheese                         8.  Onions


Diarrhea Stool

1.  Beans                           5.  Highly spiced foods

2.  Broccoli                       6. Raw fruit

3.  Alcohol                         7.  Spinach

4.  Coffee, Tea                    8.  Some drugs:  Antibiotics, etc.


Foods That Reduce Odor

1.  Buttermilk                     3.  Parsley

2.  Cranberry                    4.  Yogurt


Instructions For Use Of A One Piece Ostomy Pouch


Assemble the following equipment:

v      Warm water

v      Soap

v      Washcloth

v      New pouch

v      Measuring guide

v      Scissors

v      Mirror

v      Clamp

v      Tape


1.       Wash your hands with soap and water.

2.       Empty the pouch.

3.       Gently remove the old pouch.

4.       Rinse the stoma and skin well with warm water.

5.       Pat dry and allow the skin to dry completely.

6.       Observe the skin for redness or irritated areas.

7.       If the pouch is not pre-cut or a pattern is not available, measure the stoma using the guide.  Allow for one-eight (1/8) to one-quarter (1/4) of an inch clearance around the edges of the stoma.  Tract the outline on the paper backing of the pouch.  Cut out.

8.       Peep the paper back from the wafer just prior to application.

9.       Center the prepared pouch over the stoma.

10.   Apply light pressure to the pouch around the stoma.

11.   Apply tape to the pouch edge, if desired.

12.   If using an open-end pouch, apply the clamp.


Instructions For Use Of A Two Piece Ostomy Appliance

Assemble the following equipement:

v      Warm water

v      Soap

v      Washcloth

v      Skin barrier wafer

v      New pouch

v      Measuring guide

v      Scissors

v      Mirror

v      Clamp

v      Tape




1.       Wash your hands with soap and water.

2.       Empty the pouch.

3.       Gently remove the old pouch and skin barrier.

4.       Cleanse the skin around the stoma using soap and water.

5.       Rinse the stoma and skin well with warm water.

6.       Pat dry and allow the skin to dry completely.

7.       Observe the skin for reddened or irritated areas.

8.       If the pattern is not available, measure the stoma using the guide, allow one-eight (1/8) to one-quarter (1/4) of an inch clearance around the stoma.  Trace the outline on the paper backing of the pouch.  Cut out.

9.       Peel the paper backing from the wafer just prior to application.

10.   Center the wafer over the stoma.

11.   Apply light pressure so the wafer molds to the skin.

12.   Attach the pouch to the wafer.  Starting at the bottom of the rim, gently apply pressure around the rim.  You will feel the pouch “snap” into a secure position.

13.   Apply tape to the edges of the wafer and skin.

14.   Apply the clamp to the pouch.

15.   Wash your hands with soap and water.



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