Hi, Sarah. >> Hi, Kim. >> And you must be Tim. >> Hi. >> It's nice to meet you. >> Me too. >> So, Sarah, tell me how things been going. >> Well, [LAUGH] they've not been great. Yeah, the pain and nausea just won't go away. >> Yeah, it's it's been rough. We've been trying to manage it as best we can, but it's rough. >> Yeah, and emotionally I'm all over the place. Socially, I kind of hate everybody right now. >> Sounds like the last few weeks have been really difficult. >> Yeah. >> You want to tell me, is there anything specific and making it more difficult? >> I don't even know. I mean, do you have a take on that? >> I guess it's hard to say. I think initially we were in a fighting mode trying to take it all in, make a good plan. And then as we've settled in, I think reality's hit us. And this isn't going away and we have to wake up each day and deal with it. >> Yeah, and honestly, I don't know if I can. >> What's making you feel that way? >> I'm just worn down. I'm tired all of the time and I'm still nauseous. And even with the meds, I'm still in pain, I just don't feel good. And that makes everything else harder to deal with. I had to stop volunteering at Jesse's school, and I know that kind of sounds like a little thing, but it's a really big deal to me. because I just really enjoyed being there and it's one of the things that made me feel normal. because all the normal everyday things like cleaning or going to the store, even picking Jessie up from school, it just all feel so epic right now, yeah. >> Even the littlest things just leave her exhausted. >> Yeah. >> She's just always so so tired. >> It must be so frustrating for you. >> It is, it's been really hard and not just on me. I mean, it's been really hard on you and Jesse too. >> Going through this treatment it can be really rough. People feel like they're losing a part of themselves when they can't do the things that they normally do. >> That's exactly it. I mean, I just feel so sad and so angry that I can't just do things that used to be so normally easy. >> I'm sorry. Well, we start today by kind of talking about some of the things that are physically burdensome for you. I think if we get you feeling physically better, we can maybe start working on some of the emotional and social things coming through. This is a bit like going through a marathon. And controlling some of the physical symptoms can work on that. And then maybe we can brainstorm about some ideas to work on the other stuff that are affecting you. >> Okay, how's that sound? >> Yeah, and then that makes sense. >> Sure >> Okay. Okay, so you mentioned you're feeling really tired. >> Yeah, I'm tired all the time. I mean, the pain and the nausea I can almost sort of wrap my head around then, I kind of get where that comes from and it comes and goes, but the fatigue is just pervasive. >> All the time. >> Yeah. >> Do you think you'd be open to some strategies about ways to deal with the fatigue? >> Yes, please. >> Okay. >> Yeah. >> Okay. So one thing that works for a lot of people is scheduling rest breaks throughout the day, okay? So I know you've mentioned that you want to work or you enjoy working at your son's school and you haven't been able to. Maybe if you're able to schedule some rest time before going to the school and then scheduling some rest time after going to the school, that might be something where you might be able to fit in some time to do a meaningful activity like that. >> Yeah. I mean, that'd be tricky, but it makes sense. I mean, I, I could work on that. >> We could try that. >> Yeah. >> Okay. Another thought is finding ways to conserve energy, okay? So sitting maybe, I mean, instead of standing to do things or you can consider delegating tasks. Maybe Tim or Jesse could help out with some of the tasks that you normally do? >> Sure, we can definitely help. >> Okay. >> Well, yeah, and I mean like people at church keep asking what they can do to help so- >> Yeah. >> Yeah. >> And you know, you're not alone in this. So utilize those people, your family and friends. >> I know, I know, I know. >> Yeah, and spend your time and focus your energy on doing things that you enjoy. If you can make at least one meaningful activity a day, it makes things and the days go by a little bit less frustrating. >> Yeah, now that makes sense. I mean, we can talk some more about that. >> Okay. >> Okay. >> Yeah. >> And you also mentioned the nausea. Do you want to talk a little bit about your stomach? >> Yeah, I mean, it comes and goes, but it's definitely still a big issue and I'm taking the Zofran, but the compazine really messed me up. I think I only took that like once. >> Okay. >> Yeah. >> Okay. Well, I can talk to Dr. Ramchandran about the compazine or about thinking about some other alternative medications that might be effective instead of the compazine if you're interested. >> I don't know. I'd really rather not take any more new medications- >> Okay. >> [LAUGH] Right now since I'm on so many. >> Okay, how about some simple strategies that might work for nausea? >> Sure, okay? >> Yeah. >> What about thinking about eating what you want to eat when you want to eat it? >> [SOUND] Sounds good. >> Well, are you eating? >> She's not eating much. >> Yeah. >> Okay. So it's really important that we somehow get you the nutrients you need to have the energy to do the things you want to do. I'm thinking maybe it might be helpful to meet with one of our dietitians. >> Okay. >> They're really good at coming up with strategies to kind of give you the most nutrients that you can even sometimes in the smallest amount of food. >> Okay. >> If taking in volume of food can be difficult, and that's really normal. The other thought that comes to mind is maybe they can come up with some ideas to help curb some of the nauseous and foods that might be milder a little bit easier to ingest? >> Okay, yeah. Okay. >> And that would be helpful, yeah. >> So how about constipation? Are you taking the Senna? >> Yes, and that's been helping. >> Okay, great. >> Yeah. >> because your constipation is something that can decrease your appetite and can increase nausea. >> Right. >> Got you. >> So I'm glad we have that under control. >> Yeah. >> Okay, and anything else? How's everything else? How are you thinking about? >> Sorry, I just get these waves, I just get scared. >> Tell me more. I just feel like, I go from feeling so optimistic to just so hopeless. My mind and my body just feel so out of sync and so out of control. >> Feeling out of control can strapple a lot of anxiety for people. >> Yeah. >> Even during, do have any strategies that you've used in the past to help with these feelings? >> Well, prayer, focusing on what I need to do next. I'm focusing on Tim and Jesse and how I can be there for them. >> And are they working for you now? >> I don't know. I just feel like more and more lately I'm just in this other world and it's getting harder and harder to bring myself back, I think. >> Yeah, feeling out of control is something we hear a lot from people and there's some things that we can do to help with that, if you're interested. >> Sure. So medication is one, I know you've said in the past that you didn't really want to have more medication, but that's an option. >> The other option is things like meditation or relaxation techniques, sometimes that works for some people. Sandy Chan, who's our social worker, is really experienced at helping to guide people through meditation or teaching relaxation techniques that you can use at home. If that's something you're interested, I can always talk to her. Other people seek out support from counselors or peers or from their church or things like that. Do any of those things sound like something you might be interested in? >> Well, yeah, I think I still feel weird about the medication thing, especially since I'm already taking so many. And I do think we need to tap into our friends at church more. But I think I prefer me probably just to keep talking to you for now. Okay. And we can do that. The next time we meet, we can talk further about this and if it comes up that you're open to Ideas of meditation or relaxation. We can go there when you're ready. >> Okay. >> But right now we can just continue to have the conversations about ways to help. >> Okay. >> Okay? >> Yeah. >> Okay. Now, one of the thing I wanted to talk with you about was, I know that you had spoken with Dr. Frank, about pain. And I wanted to see how that's going and if you've been keeping your pain diary. >> No. >> [LAUGH] >> So, Sarah- >> [LAUGH] I know that sometimes it can seem like a lot to write it down. But in fact, actually it takes one less thing that you have to think about, okay? >> Yeah. >> It makes it easier for Tim and for our team to follow your pain. >> Okay. >> And for you to see where things are for you, to kind of track well, am I getting more of my pain in the morning or at night or things like that? >> Right. >> Okay? >> Now, that makes sense, yeah. >> A simple notebook. >> Okay. >> Okay? >> Okay. [LAUGH] >> Okay. So is there anything else that we haven't touched on today that be important? >> I mean, I can't think of anything. >> Okay, so let's think about what we talked about today. So what do you think you'll be able to take home from today will be helpful. >> Pop quiz. Okay, so I'm going to try to focus on meaningful activities and get a rest, both before and after. I'm going to talk to the dietitian about some ideas for the nausea. And I'll also- >> So I'll schedule the appointment for you. >> Okay. >> With the dietitian, like you said, the rest before and after, ways of conserving your energy. >> Right. >> Delegating some tasks. >> Yes. >> Right? And then, we can talk further about this kind of this feeling out of control, which I said before is really normal and ways to kind of cope with that. >> Okay. And then I'll plan to see you in a couple weeks. >> Okay. >> And if anything comes up for either you or Tim, between now and then, you have my number, you can always give us a call. >> Okay. >> Otherwise we'll plan to see you in two weeks. >> Okay, thank you. >> Okay. It's good to see you. >> Thanks, you too. >> Thanks very much. >> You are welcome.
