Symptom Management

Feeling or being sick can be due to the illness itself or can also be a side effect of some treatments or medicines:

• Eat little and often
• Get someone else to prepare food and avoid cooking smells if possible
• Avoid strong smelling, spicy or greasy foods
• Sip ginger drinks or suck boiled sweets
• An anti-sickness tablet before meals can be prescribed
• Try to relax as anxiety can make nausea worse.
• Avoid strong fragrances that may trigger nausea.

Food plays an important part in our lives so it can be upsetting when it becomes difficult to eat. Many people find there are times when they are not hungry and do not feel like eating:

• Choose foods you really enjoy
• Eat when you feel like eating – you don’t have to stick to mealtimes
• Alcohol may help your appetite – try a small glass half an hour before a meal if desired
• Make sure you have good pain relief to cover meal times
• Use distractions such as music or television when eating

If your mouth is sore, choosing foods carefully can help:

• Have milky drinks rather than fruit juices
• Eat soothing cold foods like custard, yoghurt, jelly and ice cream
• Let hot foods cool down slightly
• Avoid highly spiced foods such as curries, acidic foods such as tomatoes and dry foods such as toast
• Use a teaspoon or straw to avoid food coming into contact with the sorest part of your mouth
• Use a small soft toothbrush
• Speak to your doctor or nurse if you develop mouth ulcers or a white coating on your tongue. This might be oral thrush which is treatable

 If your mouth is dry:

• Maintain regular mouth care - every 2 hours
• Sip water or cool drinks frequently
• Suck fresh pineapple chunks
• Use a small water spray

There are many causes of constipation. Medicines such as morphine, reduced food and fluid intake and decreased mobility can all cause constipation:

• Drink enough fluid, 6-8 cups every day if you can
• Include vegetables and fruit such as kiwifruit and prunes
• Keep as active as you can • Take laxatives regularly if prescribed
• Talk with your doctor or nurse if constipation persists

Some patients who are weak and spend most of their time in bed or a chair are prone to developing pressure area problems (skin breakdown). Bony areas such as buttocks, hips, heels and elbows require special attention: Pressure Area Problems

• Change position frequently - even a small change of position might help
• Tell your nurse if you notice redness of any area. There is specialist pressure relieving equipment available that may help

Breathlessness affects people in different ways and can be distressing:

• Try to balance rest and activity. Let others help with more strenuous tasks
• Sit down and dress in stages • Climb stairs slowly
• Use extra pillows or a backrest in bed if lying flat is uncomfortable.
• Sit straight.
• Open a window or use a fan
• Drop your shoulders as you breathe out. This will help control your breathing
• A small dose of fast acting morphine elixir can be helpful if prescribed
• Try something distracting such as listening to music
• If you have tried the above without any improvement, you should contact your nurse or GP

Weakness and tiredness are very common problems for many people. They can be caused by the illness itself or be a side effect of medication or treatment and can affect all aspects of life, so it is important to get help:

• Plan difficult activities for the time of day when you feel your best
• Prioritise things that are important to you and save your energy for them
• Pace yourself – take regular rest periods
• Take gentle exercise as able
• Eat a balanced diet to help to maintain your energy levels, however it is also important to enjoy your food and eat what you can
• Talk to your doctor or nurse. They may be able to identify a treatable cause

Many people experience a roller coaster of emotions that might include numbness, fear, anxiety, anger and low mood. There may be worries about family coping, money or housing. It can be very hard to talk to people close to you about what is happening and how you are feeling:

• Accept that there will be good and bad days. Try to be honest about your feelings
• Find something to hope for – a small project, a holiday or special times spent with family and friends
• Understand that those closest to you will also need time to adjust to what is happening
• Be honest with friends and family about what will help you most e.g. meals, gardening, childcare, company
• Talk to your doctor, nurse, pastoral carer or social worker

Please contact your GP or district nurse. Advice is also available 24 hours a day, seven days a week from the hospice.