Rehabilitation


 

 

What is Rehabilitation?
Rehabilitation means basically to get the patient back to the mainstream as early as possible.

This is a very complex problem. Rehabilitation involves not just physical rehabilitation, in which we try to ensure that the patient is gainfully employed and is able to do things as closely resembling the way he used to do before, but also mental rehabilitation, so that he feels that there is a purpose to his life and he is more or less in control.

A successful rehabilitation is that one in which the person stops considering himself as a patient (leaving that to the doctor) and goes back to being a normal person, at least in mind if not in body.

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How do we support and rehabilitate these patients of cancer?
During rehabilitation, it is important for both clinicians and relatives to realise that physical recovery always outpaces emotional recovery and just the removal of the final stitch does not signify the end of the recovery phase. A significant part of the recovery process for the relatives is to be as positive as possible and to get the patient off his or her emotional crutches as early as possible.

Cancer patients have a mountain to climb. Besides all the medical challenges they have to face they have social problems, economic problems, and definite mental and psychological problems.

Some patients find this emotional burden too heavy a load to carry. These emotional problems dominate over the physical and practical aspects of their disease.

Tragically, many clinicians and family members never really have time to pay attention to what the patient is going through mentally. It is very important that the entire health care system including the surgical oncologist, the patient's general physician, the nursing staff, the family members, all get together to form an emotional support team and help improve the quality of the lives of such hapless patients by making them feel less alone.

There are cancer support groups in certain parts of the country, but the distribution is not very uniform. So the onus really falls back on the group mentioned before.

This is where you can help. Join the virtual community as a volunteer, patient or relative. This makes you a massive self supporting group which can help members in their times of strife.

Given below are several instances of specific cancer treatment where rehabilitation becomes especially important. The purpose of this is to highlight the challenges faced in the rehabilitation process.

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Rehabilitation in a few specific cancers.
Colorectal cancer patients who have been treated with a permanent colostomy have an additional burden to carry emotionally. Many of them adjust very poorly to the fact that their fecal route has been transferred to the abdominal wall and it may turn out to be an ever-present danger of causing unbearable social embarrassment. At this point in time, very early after the procedure, if the family and the doctor can convince the patient that it is really not a big problem and he can go about by passing just one motion a day and adjust emotionally, then the patient if convinced, will rarely have any problems in life as far as the colostomy is concerned.

In fact, many patients who adjust very well, even do not need a colostomy bag and after passing one single regular motion in the morning, walk around and work around the whole day with just a small gauze piece covering the colostomy. On the other hand, if at this point in time, the patient is not given adequate emotional support, then he or she may never ever be able to adjust to the colostomy and will be forever stuck with the bag, the social burden, and emotional problems.

Rehabilitation is an extremely important segment of treatment for patients with oral cancers. The goals of rehabilitation basically not only depend on the extent of the disease but also the treatment which has been offered to the patient, which is unfortunately often quite mutilating. It is a very important role that the reconstructive surgeon has to play, because it is he who will be able to decide as to how the patient is finally going to look after the surgery is over. In other words, the patient's entire social outlook is wholly dependent on how less mutilating the ultimate result is, at the same time not compromising from the adequate safety margins required for clearance of cancer.

Especially in those patients who have undergone a radical cystectomy for bladder cancer and suffer from the potential social embarassment of using an external urine collection device such as a stoma bag (although this bag is well hidden, some patients always fear scandal in public in the form of the bag bursting, etecetra), it is vitally important that the doctor, nurses and relatives get together to make the patient feel as much at home as possible. Stoma care specialists are available in most cancer hospitals to teach the patient how to comfortably take care of his or her stoma.

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