Chronic Lymphocytic Leukemia: Care Instructions

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Your Care Instructions

Leukemia is a type of cancer that causes your body to make too many blood cells, especially white blood cells. White blood cells are a part of your immune system, which helps protect you from infection and disease.

In chronic lymphocytic leukemia (CLL), your body makes large numbers of white blood cells called lymphocytes. The cells may work as they should, but your body makes too many of them. Over time, these cells may not work as well, and they may cause symptoms as they begin to crowd out healthy white blood cells and other parts of your blood.

There are several treatments for CLL, including chemotherapy, targeted therapy, or radiation therapy. But because CLL may get worse slowly, sometimes treatment can wait. Your doctor will follow your progress and let you know if or when you need treatment.

When you find out that you have cancer, you may feel many emotions and may need some help coping. Seek out family, friends, and counsellors for support. You also can do things at home to make yourself feel better while you go through treatment. Call the Canadian Cancer Society (1-888-939-3333) or visit its website at www.cancer.ca for more information.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

  • You may get medicine for nausea, vomiting, or pain (although leukemia rarely causes pain). Take your medicines exactly as prescribed. Call your doctor or nurse call line if you think you are having a problem with your medicine. You will get more details on the specific medicines your doctor prescribes.
  • Eat healthy food. If you do not feel like eating, try to eat food that has protein and extra calories to keep up your strength and prevent weight loss. Drink liquid meal replacements for extra calories and protein. Try to eat your main meal early.
  • Get some physical activity every day, but do not get too tired. Keep doing the hobbies you enjoy as your energy allows.
  • Take steps to control your stress and workload. Learn relaxation techniques.
    • Share your feelings. Stress and tension affect our emotions. By expressing your feelings to others, you may be able to understand and cope with them.
    • Consider joining a support group. Talking about a problem with your spouse, a good friend, or other people with similar problems is a good way to reduce tension and stress.
    • Express yourself through art. Try writing, dance, art, or crafts to relieve tension. Some dance, writing, or art groups may be available just for people who have cancer.
    • Be kind to your body and mind. Getting enough sleep, eating a nutritious diet, and taking time to do things you enjoy can contribute to an overall feeling of balance in your life and help reduce stress.
    • Get help if you need it. Discuss your concerns with your doctor or counsellor.
  • If you are vomiting or have diarrhea:
    • Drink plenty of fluids (enough so that your urine is light yellow or clear like water) to prevent dehydration. Choose water and other caffeine-free clear liquids. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.
    • When you are able to eat, try clear soups, mild foods, and liquids until all symptoms are gone for 12 to 48 hours. Other good choices include dry toast, crackers, cooked cereal, and gelatin dessert, such as Jell-O.
  • Avoid colds and flu. Get a pneumococcal vaccine shot. If you have had one before, ask your doctor whether you need a second dose. Get a flu shot every fall. If you must be around people with colds or flu, wash your hands often.
  • Do not smoke. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lost consciousness).
  • You vomit blood or what looks like coffee grounds.
  • You pass maroon or very bloody stools.
  • You have a fever and feel very weak.

Call your doctor or nurse call line now or seek immediate medical care if:

  • You have any unusual bleeding, such as:
    • Blood spots under the skin.
    • A nosebleed that you cannot stop.
    • Bleeding gums when you brush your teeth.
    • Blood in your urine.
    • Vaginal bleeding when you are not having your period, or heavy period bleeding.
  • You are dizzy or light-headed, or you feel like you may faint.
  • You have signs of infection, such as a fever or chills.
  • Your stools are black and tar-like or have streaks of blood.
  • You have signs of needing more fluids. You have sunken eyes and a dry mouth, and you pass only a little dark urine.
  • Vomiting has lasted longer than 24 hours and you are not able to keep fluids down.
  • You have severe diarrhea (large, loose bowel movements every 1 to 2 hours).

Watch closely for changes in your health, and be sure to contact your doctor or nurse call line if:

  • You feel much more tired than usual.
  • You have weakness that is getting worse.
  • You feel sad or anxious for a long period of time, or your feelings interfere with your normal activities or relationships.

Where can you learn more?

Go to http://www.healthwise.net/ed

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