Precautions for patients with gastrointestinal cancer chemotherapy at home

Many current chemotherapy regimens do not end in one day, such as the commonly used chemotherapy regimen for gastrointestinal cancer (XELOX), which is intravenous combined oral chemotherapy. Oxaliplatin, intravenous drip, d1; combined oral capecitabine, d1-14, and then rest for one week; every three weeks is a cycle. In this way, the patient went home and continued to take chemotherapy drugs for 2 weeks after intravenous infusion in the hospital, so most of the entire chemotherapy cycle was completed at home. &nbsp.&nbsp.There are many aspects that patients need to pay attention to during home chemotherapy: medication: complete the medication on time, do not stop or reduce the dose at will, such as the above chemotherapy regimen, capecitabine is generally twice a day, once in the morning and once in the evening , The dosage is calculated based on the body surface area. The effect of chemotherapy is related to the blood concentration. If the drug is stopped at will, it will affect the effect of chemotherapy. Oral for 2 consecutive weeks, and then stop the drug for a week. However, if the patient has a more serious side effect, it is necessary to reduce the dose or stop the drug, and the specific need to communicate with the attending doctor. In addition to chemotherapy drugs, there are adjuvant drugs, such as nausea and vomiting drugs. These drugs are generally recommended to be taken orally before chemotherapeutics, and they will be less effective if they are taken after nausea and vomiting occur. There are also liver-protecting drugs, which are also recommended for preventive use. Do not wait for abnormal liver function in laboratory tests before taking them. It takes a long time to take the medicine after the transaminase is obviously abnormal, and the effect is not good. In terms of diet: during chemotherapy, most patients will have decreased appetite or nausea and anorexia. The overall diet is mainly light. If there is no obvious gastrointestinal reaction, basically a normal diet, a combination of meat and vegetables, and even appropriate supplements of lean meat, animal liver, etc. Will improve the symptoms of anemia. As long as the patient does not have obvious vomiting, try to increase their diet, even if they drink porridge, stew soup, etc. In addition to avoiding cold during chemotherapy, it is best not to drink cold water, and there are no obvious contraindications. According to the patient’s taste, make food suitable for the patient’s taste and increase the intake, instead of giving too light food or even salt-free food like many people, this is a diet that is very unhealthy and will further reduce appetite. Chemotherapy side effects: The side effects of chemotherapy vary from person to person, with different degrees. Common gastrointestinal reactions, such as nausea and vomiting, mild nausea, and occasional vomiting can be relieved by oral antiemetic drugs, and the symptoms will gradually decrease over time, but if the vomiting is severe, intravenous fluids are needed at this time. Provide nutrition and energy instead of waiting at home. The patient will suffer from severe dehydration or electrolyte imbalance. If the patient’s diarrhea is not serious, oral antidiarrheal drugs can be used to control it. Seek medical attention promptly, do not take medicine at home, take antidiarrheal drugs in the hospital, and infusion to maintain water and electrolyte balance; peripheral neuritis, gastrointestinal tract and other patients with platinum chemotherapy drugs may have peripheral neuritis, which is numbness of hands and feet, and the influence of chemotherapy drugs Peripheral nerve endings, the patient’s hands and feet numbness, acupuncture sensation, abnormal paresthesia, aggravated by cold. Therefore, these patients should not touch cold water at home, wash their hands and feet with warm water, and do not take things in the refrigerator, especially in autumn and winter, wear gloves to keep warm. Pay attention to blood test: Because chemotherapy can cause bone marrow suppression and liver and kidney function damage, these need to be understood through blood tests and liver and kidney function. Therefore, it is recommended that patients review blood routine and liver and kidney function at least once a week during chemotherapy. The test results are timely and consistent. Communicate with the attending doctor to adjust the dose of chemotherapy based on laboratory indicators and adjust the adjuvant medication (such as whether to use white blood cell or platelet-up drugs, whether to adjust the dose and type of liver protection drugs, etc.).

Nephrologists must correct the “5 fears” as soon as possible, which is closely related to avoiding uremia

After discovering that I have kidney disease, I always feel frightened. At the beginning, what I fear most is that my kidney disease cannot be cured. What I fear most is that the kidney disease that cannot be cured will develop into uremia. However, as the treatment time gets longer and longer, more and more knowledge about kidney disease is learned. Kidney friends will have a lot of “independent opinions” and feel that they know a lot. For patients who have not studied medicine systematically, there will gradually be more and more “fear” things. From taking medicine and testing to food and drinking water, I’m afraid of it, but I’m afraid that it will cause kidney disease to be difficult to heal, or cause recurrence of kidney disease, or suddenly find that the condition is aggravated. Nephrologists must correct the “five fears” as soon as possible, which is closely related to avoiding uremia. Our nephropathy friends often have these five fears and must be corrected as soon as possible. 1. I am afraid that the medicine will not take effect immediately to treat kidney disease. It is impossible to take effect immediately without taking anti-fever medicine and painkiller. Regardless of hormones with relatively fast onset, or immunosuppressants with less onset of action, it is impossible for them to be used to treat kidney disease and reduce protein in a short period of time. A small number of kidney diseases (such as hormone-sensitive minimal change nephropathy) can take effect within 2 weeks after using hormones. More nephropathy (such as membranous nephropathy and IgA nephropathy) use hormones combined with immunosuppressive agents, which take effect within 2-4 weeks. Not much, it usually takes 4-6 weeks to see obvious results, and it may take longer. Therefore, friends with kidney disease should not always be afraid that the drug will not take effect immediately. The treating doctor should judge whether the drug’s onset time is reached according to the condition and the characteristics of the drug, and then decide whether the drug needs to be adjusted, and the kidney friend should not stop it at will. medicine. 2. There are many drugs that need to be used in the treatment of kidney disease for fear of drug dependence, such as antihypertensive drugs (such as valsartan and perindopril), hypoglycemic drugs (such as metformin, etc.), and lipid-lowering drugs (such as Atorvastatin and rosuvastatin, etc.), hormone drugs (such as prednisone acetate and methylprednisolone, etc.), immunosuppressants (such as tripterygium glycosides and tacrolimus, etc.) and other auxiliary drugs ( Such as Jinshuibao and Huangkui, etc.), the above drugs may be used for a long time, and even require long-term use. For those patients with kidney disease who need to use certain drugs for a long time, it is not drug dependence, but medical needs. For example, chronic kidney disease with high blood pressure requires long-term use of antihypertensive drugs, diabetic nephropathy requires long-term use of hypoglycemic drugs, minimal changes without hormones, lupus nephritis requires long-term maintenance of small doses of hormones, etc. It is the condition of the disease. When there are no obvious side effects, only one or two drugs can be used to control the condition. Why bother to take such a medicine? 3. Afraid of side effects from taking medicine. Any medicine may have side effects. You don’t need to take medicine if you don’t get sick. Of course, you don’t worry about the side effects of medicine. The key is that I am sick, and I have a very annoying kidney disease. I have to use powerful drugs to cure the kidney disease. After you get sick, if you don’t use medicine, your kidney disease will not get better, and you will even be life-threatening; if you use medicine, you may have side effects. This requires the doctor to “weigh the pros and cons” based on the specific condition of the disease, rather than blindly fear the side effects of drugs. Doctors need to find a “balance” between kidney disease treatment and the side effects of drugs. Even if there are some side effects, as long as the benefits outweigh the disadvantages, you should still choose to use them boldly. This requires experienced nephrologists to make accurate judgments based on the disease state of the patient at that time. 4. Don’t dare to test if you are afraid of bad results. We found that many nephropathy patients have been suffering from kidney disease for a long time. Many nephrologists did not dare to face the laboratory examination. As a result, they should go to the hospital for follow-up visits to see a doctor for relevant laboratory examinations, but they could not go. In the end, I am afraid that the test results are not good and dare not go for the test. Since chronic kidney disease always feels nothing, but the condition still progresses slowly without knowing it, this provides reasons and excuses for patients with kidney disease who have not been tested. For example, a patient with kidney disease who originally had chronic renal insufficiency with a blood creatinine of only 180 μmol/L has not been tested for blood creatinine for 2 months, and it seems to be nothing. I bought some medicine at the pharmacy, and there was no abnormality in 4 months. Don’t go to the hospital (for fear of seeing a doctor, I don’t want to face it). It dragged on for a year, and it really couldn’t be delayed. When I came to the hospital for a kidney function test, the patient’s blood creatinine had risen to 600μmol/L. It turns out that he should have adjusted his medicine and treatment plan long ago, but he was afraid of bad results

These performances of the body indicate hyperlipidemia? Doctors rumors: can not judge blood lipids only by external performance

When you go to the hospital, if you ask a cardio-cerebral vascular doctor: “I have any changes in my body, it will prompt high blood fat, or high blood pressure and high blood sugar?” The real cardio-cerebral vascular doctor will definitely answer: “Most of the three highs are from the outside. What can’t be seen is that blood pressure must be measured and blood glucose and lipid can be accurately judged by blood test.” Medicine has developed to today, for the three highs, if there are people looking at the changes in the body to judge whether the blood lipids, blood sugar and blood pressure are high, So most of the results are: myocardial infarction and cerebral infarction have occurred. Because most of the three highs will not have any changes in the early stage, as long as the three highs are damaged for a long time, the heart, brain, kidneys and large blood vessels will be damaged. There will definitely be physical changes, but not only physical changes, but major diseases, even irreversible, such as myocardial infarction and cerebral infarction. Blood lipids are divided into cholesterol and triglycerides, and high cholesterol is also divided into two types: one is familial hypercholesterolemia, and the other is our common hypercholesterolemia. If you have to say what changes will happen to the hyperlipidic body, then it generally refers to familial hypercholesterolemia. Because to diagnose a person with a family history of hypercholesterolemia, it is necessary to look at the external performance, and then further blood tests are required. In other words, even if this familial hypercholesterolemia depends on external performance, it must eventually pass a test. This is a very accurate, quantitative and qualitative method to confirm whether it is hyperlipidemia. Not just looking at external performance. 1. Familial hypercholesterolemia, what is the appearance of the appearance 1, the elderly ring elderly ring, generally more common in the elderly; but if it appears in young people or adolescents, then most of them are hypercholesterolemia, need to be checked as soon as possible Bleeding fat. 2. Yellow tumors can form flat yellow tumors on the eyelids, and can also be seen in the formation of nodular yellow tumors at the elbows and knees; with age, tendon yellow tumors are more common. If you find a yellow tumor, you also need to detect blood lipids as soon as possible to see if there is high blood lipids. This is the most common hyperlipidemia and a meaningful external manifestation. For young people, or people with a family history of hypercholesterolemia, if there are senile rings or xanthomas, most of them may be hyperlipidemia. But it cannot be 100%, and further blood tests are needed. Second, severe hyperlipidemia may have some very high hyperlipidemia, whether it is high cholesterol or high triglycerides, if the blood lipids are much higher, then a small number of people will indeed have some symptoms, such as dizziness, dizziness, Unremarkable performances such as lack of energy, blurred vision, cramps, etc. That is to say, even if these performances are not necessarily high blood lipids, it is necessary to further blood tests. Even if it is hyperlipidemia, it is ultimately necessary to determine whether it is hyperlipidemia through a blood test. 3. Long-term high blood lipids If long-term high blood lipids are not found, then over time will lead to complications. Increased blood lipids such as low-density lipoprotein and triglycerides will produce more vascular waste, which will aggravate atherosclerosis, which will lead to stenosis of blood vessels, cause ischemia, and even cause coronary heart disease, carotid plaque, myocardial infarction, Angina, cerebral infarction and other diseases. When I went to the hospital to see these cardiovascular and cerebrovascular diseases, I found out that I was hyperlipidemia. Therefore, for most people, they should not wait for any performance from their bodies to doubt whether they have high blood lipids, but to take a blood test to see if their blood lipids are high or not. Fourth, how to judge whether your blood lipids are high or not? We said that no matter what kind of high blood lipids, in the end must be qualitatively determined by blood tests. 1. Those with senile rings or xanthomas must check the blood lipids as soon as possible to see if the blood lipids are not high; 2. Those with a family history of familial hypercholesterolemia must also review the blood lipids once a year; 3. Health People, men over 40 years old, women after menopause should check the blood lipids four times; 4. Hypertension, diabetes, coronary heart disease, cerebrovascular disease, carotid plaque, blood lipids should be checked every six months Four items. In short, only a very small number of familial hypercholesterolemia can be found to have high blood fat through the elderly ring or xanthoma; for most patients with high blood fat, there is no special external manifestation, and they must pass the blood test to see further Look at how high cholesterol, low density lipoprotein, high density lipoprotein, triglycerides, etc. are. Only by accurately testing the four items of blood lipids, can we determine whether there is high blood lipids, and then further control