Leukemia and Lymphoma Foundation is glad that the participants are enjoying themselves and we hope that this series of Art & Craft Workshop will be beneficial for them…

Attached is a slideshow of the 2nd week sessions…Art&Craft Workshops_Week 2

Beneficiaries’ Support Programme is targeted at beneficiaries who are newly diagnosed or suffering from a relapse of their medical condition. The support and friendship that the beneficiaries receive from their befrienders will help them to build resilience so that they are better equipped to withstand the negative emotions and/or doubts which may arise during their treatment period prior to remission.

Each befriending relationship will be unique as befrienders will be specially matched with the beneficiaries according to their life experiences and/or backgrounds.

Befrienders will be from diverse backgrounds and they will be volunteers who are above 21 years of age, have a heart for our beneficiaries and enjoy befriending them. Befrienders are required to have a basic certification in counselling. Befrienders are required to make a minimum commitment of 6 months with a minimum of 2 meetings per month with each beneficiary attached to them. Within the same period of 6 months, each befriender can only take on a maximum of 2 beneficiaries. Befrienders are required to submit a monthly report to update LLF about the progress of their sessions with beneficiaries. Befrienders are required to inform LLF of the dates which they will meet the beneficiaries for the month by the beginning of each month. In the event of a change in date/s, befrienders are to inform LLF in advance.

LLF will work hand-in-hand with the befrienders to provide training that will equip the befrienders with skills to build strong befriending relationships with their beneficiaries. Prior to the start of a befriending relationship, all befrienders are required to attend a briefing cum training session. Support groups and on-going training during the befriending process will be provided to help befrienders have more meaningful sessions with their beneficiaries. This in turn gives befrienders valuable learning opportunities for their own personal development.

In the long run, this programme can be extended to non-beneficiaries.

For those who are interested to be a befriender, please feel free to contact Crystal @ 6397 2374 or crystal@llf.org.sg.

There are many reasons for loss of appetite. These include the physical side-effects of
treatment as well as the psychological ones. Fear, anxiety and/or depression can all impact upon your desire for food. Most people find that although their appetite improves once they finish treatment, and/or leave hospital, it often takes some time before they are able to eat as much as they used to.

Rather than eating regular large meals, try eating small amounts of nutritious food more frequently (every couple of hours). This will help keep up your energy levels throughout the day.

Cancer treatment may especially deplete your body of protein. Try to eat three or four serves of protein a day, e.g. meat, chicken, fish, nuts, dairy, eggs, legumes.

It is always important to drink fluids so that you don’t become dehydrated. Nutritious
drinks like milkshakes, smoothies, high-protein soups and high-protein /high-energy drinks can make good substitutes for solid food during this period.

Try to listen to what your body is telling you and think about food in terms of taste and enjoyment first, then as a source of energy and nutrients for your body. The best food to
eat will be those you enjoy.

Try improving your appetite and your interest in food by using:

• Colour. Try more colourful fruits and/or vegetables, like tomatoes, pumpkin, red and green capsicum, beetroot, and carrots, and other food like tomato pasta sauce, roasted vegies, spaghetti bolognaise or pasta with pesto sauce.
• Smell. Try food which smells great such as fresh baked bread, fried onions and garlic, roasted chicken, hearty soups or cinnamon or nutmeg in desserts.
• Texture. Try food with different textures like: crisp lettuce or rice crackers, soft bananas and custards (especially when your mouth is sore) and crunchy raw vegetables like carrots or celery, brazil, macadamia or almond nuts (these also stimulate saliva production).

Some cancer treatments affect the production of saliva, which can cause a dry mouth.

• Increase the amount of fluids you drink each day
• Avoid dry food – you may need to add extra sauce or gravy to moisten dishes
• Rinse your mouth with water or a recommended solution after food or as necessary to help stimulate saliva production

To help stimulate saliva production:

• Rinse your mouth with cold water regularly
• Suck hard sugar free lollies (or soft jellies if your mouth is sore), or chew gum

• Using a soft toothbrush and mild toothpaste (if recommended), gently brush your teeth after every meal
• Use a soft floss after every meal unless your gums are sensitive
• Rinse your mouth with water or a solution recommended by your doctor, dentist or nurse after every meal and every one to two hours when it feels sore
• Choose mouthwashes that are alcohol free and designed for sensitive mouths

A sore mouth or throat, also known as mucositis, is a common and uncomfortable side-effect of some cancer treatments. It usually starts about a week after the treatment has finished and goes away a couple of weeks later. During this time your mouth and throat could get quite sore and it may be difficult to eat. Soluble paracetamol and other topical drugs (ones which can be applied to the sore area) can help. If the pain becomes more
severe, stronger painkillers might be needed.

• Take painkillers as prescribed
• Keep your mouth as clean as possible
• If you normally wear dentures, remove them once you feel your mouth becoming sensitive
• Avoid food that can irritate your mouth. These may include citrus fruit juices, citrus fruits, spicy or salty food and alcohol.
• Choose soft, moist food that are easier to swallow. Examples:

1.                  Cool/warm broth or soup with pureed meat and vegetables
2.                  Minced meat or fish with sauce
3.                  Milk or soy milkshake with honey, lecithin and yoghurt
4.                  Yoghurt with natural honey (for extra energy)
5.   Soft dessert, e.g. custard, mousses, crème caramels, rice puddings, ice  cream
6.                  Pasta with sauce
7.                  Eggs and egg dishes such as omelette, scrambled egg
8.                  Soft or pureed fruit, e.g. stewed apple, pear, prune, peach, watermelon
9.                  Bread dipped in egg and lightly fried served with honey and cinnamon

• Take anti-nausea medication as prescribed
• Avoid eating just before or shortly after treatment
• Don’t go for long periods without eating, as this may make your nausea worse
• Have smaller meals more frequently during the day, rather than a few large ones
• Ensure you are having cool, clear, unsweetened fluids like water or diluted juice (e.g. pear, mango) or nectar. Sip on broths, herbal teas (like green tea, ginger tea or raspberry leaf tea), ginger ale, and/or blackcurrant juice
• Get some fresh air and avoid strong or offensive smells. Avoid being in the kitchen when meals are being prepared
• If you feel better, eat some dry toast or crackers or stewed fruit
• Dry salty food (e.g. crackers) and soft drinks (e.g. ginger ale) are often well tolerated
• Eat cold food or those served at room temperature to minimise odours and preparation. Try eating small amounts of natural yoghurt
• A grated apple, ginger or papaya may help to settle nausea
• Try to eat small amounts of white rice when nausea or vomiting subsides
• Limit fatty and fried food, as these take longer to pass through your stomach, causing more nausea
• If you are unable to eat any solid food, it is still important to drink plenty of fluids (about eight to ten glasses a day) so that you don’t become dehydrated. Soups or high-protein high-energy drinks can make good substitutes for solid food during this time. Be sure to tell the doctor, nurse or dietician if you are unable to drink or eat much.
• You will receive anti-emetics (anti-nausea drugs) on a regular basis, before and for a few days after your treatment has completed. Be sure to tell the nurses and doctors if the nausea or vomiting persists for longer, or if you think that the anti-emetics are not working for you. There are many different types of anti-emetics that can be tried.

The side-effects of commonly used cancer treatments (like chemotherapy and radiation therapy) place extra demands on your body for energy and nutrients. At the same time the side-effects of these treatments and the cancer itself can affect your normal eating patterns, reducing your desire for food and your ability to eat the amount or type of food you normally would.

Side-effects and their severity can vary from person to person depending on the type of disease involved, the treatment used and how an individual responds. Some side-effects that can affect normal eating patterns may include the following:

-       Nausea (feeling sick) and vomiting

-       Sore mouth and throat

-       Loss of appetite

-       Changes in taste and smell

-       Diarrhoea and/or constipation

-       Fatigue

There is no doubt that these side-effects can be very unpleasant at times but it’s good to remember that most of them are temporary and reversible. It is important that you report any side-effects you are experiencing to your doctor or nurse because many of them can be treated successfully, reducing any unnecessary discomfort for you. In addition, the
kinds of food you eat during and after treatment can also help by reducing the severity of side-effects, and in some cases preventing them.

When you are first diagnosed, you have a great deal to cope with both emotionally and physically. The shock of the diagnosis may mean you don’t want to eat or even think about food.

Eating well before your treatment begins can help to give you more energy and strength to cope with treatment.

Many people find that their normal pattern of eating changes while they are having treatment. During treatment and for some time afterwards you may not feel like cooking or eating the same amount or the same types of food as usual. This is normal.

Many people lose weight during treatment. This is particularly true for people undergoing their first intensive hospital period after the diagnosis of acute leukaemia or those undergoing a bone marrow or stem cell transplant. If you are having a transplant you may wish to prepare your body beforehand by choosing to eat more protein-rich food and by having some regular exercise.

Here are some tips to help prepare your body and build up your strength before a bone marrow or stem cell transplant:

-         Eat small nutritious meals often during the day and include protein with your meals

-         Try to do aerobic exercise like walking at least three times a week

-         Exercise with a friend

-         If you feel okay, try some light weights to build up muscle strength but go easy and only train with weights every second day on a different muscle group, e.g. upper body and arms one day, abdominals and legs another day (no more than 2-3 times/week)

-         Drink plenty of water (when training, sip water every 15 minutes)

-         Get plenty of rest and sleep

-         If you can, go away for a short holiday with family or friends before your treatment begins

-         Make the most of this time to really get fit, healthy and positive. It will serve you well throughout the coming months.

Before you start treatment it is a good idea to have a dental check-up. It is important to make sure that your teeth are in the best possible condition before treatment begins. After treatment your gums may be too sensitive for dental work.

* This information booklet is available for browsing at Leukemia and Lymphoma Foundation, located at Novena Medical Centre, Singapore. Alternatively, for more information, you can visit the website of Leukaemia Foundation.