Home care for patients with multiple myeloma

  The treatment and recovery of multiple myeloma takes a long time. In addition to the necessary hospitalization, patients spend most of their time at home for physical recovery, so the family becomes the “ward” for rest and recovery, and the family members become the “nurses” in the “ward”. “He or she should not only take care of the patient’s diet and living, but also do a good job of nursing according to the requirements of disease treatment, such as supervising the patient to take medication on time, observing whether there is any drug reaction, making nutritious recipes, assisting in functional recovery exercises, doing a good job of cleaning and hygiene, and supervising the patient to go to the hospital for regular review and treatment, etc. Whether home care is in place or not is very closely related to the patient’s recovery.  So, what basic knowledge should family members have? First of all, family members should know about the clinical manifestations, treatment methods, precautions for taking medication and diet of multiple myeloma disease, and secondly, they should know the course of the disease, common signs and symptoms, treatment methods and prognosis. With this knowledge, family members can know how to help the patient and how to cope with the disease together with the patient, help the patient treat the disease correctly and maintain a positive and optimistic attitude to facilitate the recovery of the disease.  Patients with multiple myeloma are often hospitalized repeatedly, and some of them may be bedridden for a long time. The pain of the disease can easily make them have negative emotions such as anxiety, depression, irritability, loneliness, and fear of being abandoned by their families. In this regard, family members and friends should take the initiative to contact the patients, provide extra care and attention, communicate with them frequently to understand their psychological state, eliminate their loneliness, and understand their needs and help them solve their difficulties as much as possible, so that the patients can face the reality, maintain stable emotions and build confidence to overcome the disease.  Multiple myeloma itself and certain medications may cause peripheral neuropathy, and patients may experience numbness and other sensory abnormalities in their hands and feet. Family members should usually pay attention to whether patients have symptoms of neuropathy, and if new or aggravated symptoms of peripheral neuropathy appear, such as skin sensory allergy, numbness, tingling or burning sensation in the limbs, or pain in the hands and feet, they must immediately seek help from the patient’s competent physician.  Bone pain is the most common symptom in patients with multiple myeloma. When patients have severe bone pain, they should reduce noise stimulation in the home and reduce their activities, keep the room softly lit, and adopt relaxation techniques (e.g., watching TV, listening to music, etc.) to distract themselves from the pain and put their bodies in a comfortable position. If bone pain remains uncontrolled, contact the patient’s supervising physician as soon as possible, as bone pain is an indication that the disease is progressing and the patient may need to move on to the next course of chemotherapy.  Patients with multiple myeloma are prone to spontaneous fractures due to the destruction of bone by myeloma cells. Except for spinal compression fractures or pelvic fractures that require bed rest, patients should be encouraged to move appropriately to prevent further osteoporosis. Patients should wear flat heeled shoes with teeth, walk gently, turn and bend slowly, and not go to crowded places. Patients should preferably sleep in a hard bed, and the bed should be stable and should not be shaken.  In terms of diet, patients should be instructed to supplement a balanced diet that is high in protein, vitamins, nutritious, soft and easy to digest, such as lean meat, eggs, peanuts, milk, carrots, yellow and green vegetables, etc. Pay attention to dietary hygiene, do not eat food with too hard bone spurs, so as not to damage the gums and cause bleeding of the oral mucosa. It is not advisable to drink strong tea and coffee, and avoid spicy and other stimulating foods. When patients are infected, they will consume a lot of protein, calories and water due to high fever, so they should be given light and easily digestible protein in time. Therefore, it is advisable to eat a soft diet with high protein, high calories and high vitamins, and eat more coarse fiber foods such as fresh fruits and vegetables, especially for bedridden patients, to prevent constipation.  The goal of treatment for multiple myeloma focuses on prolonging survival and improving life treatment. Maintaining good communication with your supervising physician, regular review and on-time treatment are the basis for achieving this goal. In addition, careful care and psychological attention from family members are also crucial to the patient’s recovery. I also hope that all patients with multiple myeloma will have a positive attitude to face the disease. In fact, many patients are able to live like normal people and even return to work through active treatment.