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50 / 50 portrays the story of a timid, introverted man who gets diagnosed with shwannoma neurofibrosarcoma, which is a malignant tumor in his spine. Cancer is a major health problem and has multiple physical effects related to the uncontrolled and unregulated growth of cells.
50 / 50 portrays the story of a timid, introverted man who gets diagnosed with shwannoma neurofibrosarcoma, which is a malignant tumor in his spine. Cancer is a major health problem and has multiple physical effects related to the uncontrolled and unregulated growth of cells.
50 / 50 portrays the story of a timid, introverted man who gets diagnosed with shwannoma neurofibrosarcoma, which is a malignant tumor in his spine. Cancer is a major health problem and has multiple physical effects related to the uncontrolled and unregulated growth of cells.
EXPERIENCING A HEALTH CHALLENGE: THE EFFECTS ON CLIENTS 50/502
The movie 50/50 portrays the story of Adam, a timid, introverted man who gets diagnosed with shwannoma neurofibrosarcoma, which is a malignant tumor in his spine. Adam lives a mundane life, which is hindered by his severe back pain. Once he finally seeks medical attention for this, he learns of his cancer. After doing Internet research on his diagnosis he finds that his odds for survival is 50/50. Along with him, his mother and girlfriend have difficulty coping with his diagnosis. His mother becomes very over bearing and anxious, insisting on moving in to take care of him. His girlfriend Rachel becomes very uncomfortable with the fact that his illness is possibly terminal and becomes unfaithful to Adam. Initially, Adam undergoes chemotherapy to treat his cancer. However, it had no effect in curing him. The last option for Adam was to resort to an invasive, high-risk surgery that Adam decided to take. The surgery was successful and Adam was on the road to recovery. Cancer is a major health problem and has multiple physical effects related to the uncontrolled and unregulated growth of cells (Lewis, 2014, p. 347). Adams back pain was so severe that it was affecting his daily life. He constantly complained of pain while sitting at his desk at work, walking for too long, riding his bicycle and his pain also hindered his sexual performance. According to Lewis (2014), Compression or infiltration of tumor involving nerves causes pain (p. 369). Considering that Adams tumor is located on his spine which is a highly concentrated with nerves, this is a plausible cause of pain. Another cause of pain according to Lewis (2014) could be the inflammation, ulceration or necrosis of tissues caused by cancer cells (p. 369). The other physical effects that Adam experiences in the movie are side effects of his chemotherapy treatments. The Canadian Cancer Society describes chemotherapy as drugs that destroy cancer cells (2014). However, these types of drugs can also damage healthy cells, which can cause multiple side effects (Canadian Cancer Society, 2014). Throughout the movie after
EXPERIENCING A HEALTH CHALLENGE: THE EFFECTS ON CLIENTS 50/503
undergoing chemotherapy treatments, Adam was very lethargic. He would appear pale with bags underneath his eyes and spoke slowly as if he was on the verge of falling asleep. When constantly asked to party with his out-going friend Kyle, Adam always refused as he was too tired and wanted to go to sleep. According to Lewis (2014), fatigue is a commonly reported adverse effect of cancer therapy, affecting 70% to 100% of patients with cancer (p. 367). In the movie, Adam is constantly vomiting or feeling nauseated. Cellular breakdown caused by chemotherapy stimulates the vomiting center of the brain (Lewis, 2014, p.366). The drugs taken to treat cancer and the destruction of the gastrointestinal lining can also cause vomiting (Lewis, 2014, p.367) His friends who he had made during chemotherapy treatments suggested smoking marijuana to help alleviate this symptom. Studies conducted have shown that cannabis is highly effective in relieving nausea (Tramer et al., 2001). These three physical effects are very evident in the movie, but are only few of the effects that cancer can have on a patient. Along with the physical effects, Adam as well as his loved ones also bears the psychosocial effects of this health challenge. Firstly, in the movie it is witnessed when his mother discovers the news of his diagnosis. She is seen to have a mental breakdown and goes into a fit of crying, yelling, and even hitting. Since Adam was previously estranged from his mother, she is further distressed at the thought of possibly losing her son. The diagnosis of cancer in ones child marks the beginning of social and psychological devastation for the whole family, especially the mother (Ghufran et al., 2014). Adams girlfriend Rachel at first was very supportive. She drove him to his chemotherapy sessions, provided him with support, comfort and care when he was first diagnosed. However, the idea of him being terminally ill troubled her. She only dropped him off at his cancer related appointments, but didnt accompany him, as she didnt feel comfortable in the hospital environment. Eventually the pressure of having to take care of
EXPERIENCING A HEALTH CHALLENGE: THE EFFECTS ON CLIENTS 50/504
her partner took a toll on the relationship as Rachel became unfaithful. According to Goodfellow, the psychological and physiological disturbances of cancer patients can cause high levels of stress in their spouses (2014). Fear, lack of knowledge about treatment and having to adjust daily activities are factors that make spouses unsure about the future (Goodfellow, 2014); therefore, could have lead to Rachels infidelity. When Adam received his diagnosis of his cancer he was initially confused. He felt this way as he leads a very healthy and precautious lifestyle. He tries to prevent death to the best of his abilities, including not getting his drivers license because he thought driving was dangerous. When his doctor disclosed his diagnosis he responded by saying This cant be true, I dont even smoke. The initial shock, denial and disbelief are common among people who have their diagnosis confirmed (Trill, 2012). As his cancer progresses Adam feels helpless. He tried his whole life to avoid unfortunate circumstances; however, as he cannot control his cancer, he feels tired and wants it to be over. He tries to crash his friends car to try and end his own life. Recurrent thoughts of suicide, and attempting suicide are common amongst cancer patients who face major depression (Trill, 2012). When providing holistic nursing care for Adam, the priority would be to relieve his pain. Pain is defined as an unpleasant, subjective sensory and emotional experience associated with actual or potential tissue damage (Potter et al., 2014, p.1017). Addressing Adams pain will improve his physical and psychological well being. When treating pain, studies have suggested that a multidisciplinary approach should be taken when relieving chronic back pain rather than individualistic treatments for example resorting only to drug therapy, or physiotherapy. The results presented the benefits of multidisciplinary treatments to not only improve pain, but also mood as well as behavior in patients (Flor et al., 1992). Alleviating pain is a holistic priority because it causes suffering and reduces the quality of life (Lewis, 2014, p. 154). Pain is the
EXPERIENCING A HEALTH CHALLENGE: THE EFFECTS ON CLIENTS 50/505
initial reason why Adam sought after care. According to Potter et al. (2014), pain is the most common reason for people to seek care (p. 1017). Relieving Adams chronic back pain will help him adjust better to daily life. In the movie his pain was mainly what hindered his day-today routine as well as his relationships. To address Adams priority concern of pain, the nurse has many responsibilities when providing care. The first intervention would be for the nurse to administer the clients pain medications. Because of the severity and invasiveness of the drug therapy, the nurse should be very precautious before and after administration of medications. A thorough head to toe assessment, vital signs and a pain assessment should be done in order to monitor how the patient is tolerating his treatments as well as gaining a better understanding of the pain. According to Jarvis et al. (2014), the ability to measure pain is an important component of a comprehensive assessment (p. 186). Ultimately, understanding the patients pain will enhance the nurses ability to provide care. Vital signs such as increased blood pressure, pulse and respirations could indicate pain. The use of analgesic medication, especially narcotics will depress these vital signs along with the central nervous system (Lilley, 2014, p.204). Thus, when administering medication for pain it is also important to constantly monitor the clients neurological status along with the vital signs and pain assessments. The second nursing intervention is to alleviate the back pain by reducing the pressure on the area affected by the tumor. Using special pillows such as donut cushions could help alleviate pressure on the coccyx area. Laying the patient on their side could help take the pressure off of their back. Providing patient education is an important intervention that the nurse should implement to reduce pain. Health promotion enables individuals to gain control over and improve their health and well being (Potter et al., 2014, 1036). Educating the patient about pain makes it a
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decision-making process for the client and family. This helps reduce anxiety and increase selfcontrol. According to Potter et al. (2014), Fear increases the perception of painful stimuli(p. 1036). Therefore, by reducing fear and anxiety, pain becomes more manageable. The nurse could implement health teaching about relaxation methods to reduce pain. Deep breathing and relaxation through guided imagery are non-pharmacological techniques that could help alter perceptions of pain (Potter et al., 2014, p. 1036). When dealing with such a life-threatening and serious illness such as cancer, collaborative care is critical in treatment. To provide collaborative care, there has to be a team of inter-professional members that implement strategies in the best interest of the client and to assist in recovery. Firstly, to relieve the immediate stimuli of pain is to remove the tumor in the spine, which is done by the surgeons. Post surgery, nurses monitor the client with frequent assessments of vital signs and pain, administering medications and providing care ordered by the Doctors. After removal of the tumor, it is important for the patient to be able to return to performing daily activities. Physiotherapy plays a big role in helping increase range of movement and walking after surgery. Spinal surgery is quite invasive and is a high-risk procedure as it could easily paralyze a client or could even be fatal. To prepare for this, psychologists help develop coping mechanisms as well as stress relieving exercises for clients. Breathing and calming strategies could help distract the client from pain as well as manage anxiety of their condition and dealing with the possibility of death. This occurred in the movie with Adam, and his psychologist Katherine. There are many community resources that reach out to people who have cancer. At Wellspring there are many volunteers who have cancer as well. These volunteers provide comfort and guidance for patients as well as their family members who are facing the
EXPERIENCING A HEALTH CHALLENGE: THE EFFECTS ON CLIENTS 50/507
challenges of cancer. This association provides access to a wide range of expertly led programs and services to help cope and manage the impact of cancer on patients and their families lives. Wellsprings programs range from music therapy to healing touch to help alleviate stress and pain. The Canadian Cancer Society is another community resource that patients could utilize. They recommend coping with pain by talking about it. Verbalizing pain will assist others to find an effective way to relieve it. There are multiple other support groups to help with the battle of cancer. The best way to cope for the patients is to know that they are not alone and that there is hope in recovery as there was for Adam in 50/50.
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References Canadian Cancer Society. (2014). Chemotherapy. Retrieved from http://www.cancer.ca/en/cancer-information/diagnosis-and-treatment/chemotherapy-andother-drug-therapies/chemotherapy/?region=on Flor, H., Fydrich, T., Turk, D. (1992). Efficacy of multidisciplinary pain treatment centers: a meta-analytic review. Pain, 49 (2), 221-230. Ghufran, M., Andrades, M., & Nanji, K. (2014). Frequency and severity of depression among mothers of children with cancer. British Journal of Medical Practitioners, 7.1, 11. Goodfellow, L. M. (2013). Dont forget the partner of a patent with cancer. Oncology Nursing News. Retrieved from http://nursing.onclive.com/publications/oncologynurse/2013/February-2013/Dont-Forget-the-Partner-of-a-Patient-WithCancer#sthash.FEBAafYW.dpuf Jarvis, C., Browne, A., Macdonald-Jenkins, J., Luctkar-Flude, M. (2014). Physical Examination and Health Assessment. Toronto, ON: Reed Elsevier. Lewis, S. L. (2014). Medical-surgical nursing in Canada. Toronto, ON: Reed Elsevier. Lilly, L. L., (2011). Pharmacology for Canadian Health Care Practice. Toronto, ON: Reed Elsevier Potter, P., Perry, A., Ross-Kerr, J., Wood, M., Astle, B., Duggleby, W (2014). Canadian Fundamentals of Nursing, 5th Edition. Toronto, ON: Reed Elsevier. Reiser, W. & Levine, J. (September 30, 2011). 50/50. USA. Summit Entertainment. Tramer, M. R., Carroll, D., Campbell, F. A., Reynolds, J., Moore, A., McQuay, H. (2001). Cannabinoids for control of chemotherapy induced nausea and vomiting: quantitative systematic review. British Medical Journal.
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