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As a pediatrician and a parent navigating this pandemic, I worry sometimes that an important point gets lost in the midst of all the helpful posts about things to do with your children in cramped spaces, homeschooling, and other tips for managing the current reality:
This is bad for the mental health of each and every one of us.
Let’s review: We were going about our business as usual and suddenly a possibly deadly virus appeared and shut down life as we knew it. School and daycare closed, and our children were home without any structure or activity except what we create or enforce. Every trip out of the house became treacherous. For those who can’t work from home, work either became dangerous or it disappeared, taking income with it. Supplies became precarious. Interactions with anyone outside our home became almost entirely virtual or nonexistent.
There is no way that we can live this without anxiety and sadness — and no way that our children can live it without anxiety and sadness. We all need to do our best, sure, but it’s important that we acknowledge that we are feeling strange and bad, that our kids are too, and this can’t help but affect how we all behave. We have to take care of ourselves in a different way, being proactive about our mental health.
Keep to a schedule — but be realistic. Having a daily schedule is important, especially for children, and you should make one and stick to it. However, don’t get too ambitious. If you have school-age children, make sure they have enough time allotted to get their work done (this will vary from child to child), but don’t feel obligated to make it as long as they would have been in school — or have the hours match school hours (if your children have never been early morning people, why force it now?). If your child is not able to get the work done, and you’ve reached out to the school and tried everything they suggested, cut both of you some slack; most of us parents are not trained teachers, and we’ll figure out how to fix it all when this is over. On the flip side, if your children are interested in reading great literature, learning a new language, or otherwise gaining extra knowledge and skills during this time, go for it — but don’t force it. Keep the bar low.
Schedule self-care. All family members should have time set aside to do what makes them happy. Be deliberate about that.
Schedule fun. Bake cookies, play a game, be silly, make messes. Be deliberate about that, too.
Make sure everyone gets enough sleep — and that they stay on a regular sleep schedule. Shut off the screens in the evening, stop the video games, and set an alarm clock in the morning. Inadequate or irregular sleep will make everything worse.
Make exercise a priority. Exercise makes all the difference for our physical and mental health. If you can go outside safely, do that; take a daily family walk, for example. If you can’t get outside, have a daily dance party. Do yoga — it doesn’t take up much space, and helps with stress. There are plenty of videos out there to show you how.
Use tech to connect with people. Set time aside every day to call or FaceTime people — maybe some friends and family you have lost contact with over the years (more people are home now!). Set up virtual play dates and other virtual gatherings.
Put yourself on a media diet. Yes, we need to keep abreast of the news. But obsessively clicking on links will only make you more anxious.
Stress kindness and be patient. We all get cranky and mean when we are anxious and sad. This situation is likely to bring out our bad sides. Have house rules on how you treat each other. Take a breath and try to redirect yourself before you yell at your kid or snap at your partner (or worse). If just a breath won’t do it, take a moment. Walk away.
Understand that the usual stress management strategies might not work. These are extraordinary times, and the things that you usually do to help yourself or your children may not be enough. Call your doctor or your child’s doctor; they know you and your situation best and can help.
There are also resources that can help, such as:
It’s especially important that you reach out if you are feeling like you might hurt yourself or someone else. But don’t wait for that. Make changes, and ask for help if you need it, right now.
The post Not a staycation: Isolating at home affects our mental health (and what to do) appeared first on Harvard Health Blog.
Treatment for cancer is a difficult time for patients and their families. While there are significant benefits of chemotherapy in treating and managing many types of cancers, some of the negative side effects may not always be so obvious. One of the potential negative effects of chemotherapy that you may not be aware of is hearing loss. Hearing loss caused by chemotherapy is generally considered a type of sudden hearing loss, so monitoring hearing before and after treatment with hearing tests is important.
Hearing loss as a potential side effect of chemotherapy is more likely with chemotherapies that fall into the category of platinum-based drugs, such as cisplatin or carboplatin. Cisplatin therapy is used in a variety of treatment protocols, but it is most commonly used in gynecological (ovarian and cervical) and head and neck cancers. In addition to cisplatin, there are reports of hearing loss with some immune-targeted melanoma therapies. The way chemotherapy causes hearing loss is complex, but ultimately it causes permanent damage to the inner ear cells responsible for hearing. Importantly, hearing loss often affects high-pitched hearing, which has little impact on your daily hearing needs.
There are certain factors that may increase the risk of hearing loss, and if you are scheduled to get the types of therapies mentioned, it is important that you discuss risk factors for chemotherapy-induced hearing loss with your oncology team.
Symptoms of hearing loss may be accompanied by a ringing in the ears, or tinnitus. One of the most reliable ways to know if your hearing has been affected by chemotherapy is to get your hearing tested with an audiologist or ear, nose, and throat physician (otologist). It is important to have your hearing tested before and after chemotherapy; the status of your hearing before treatment will serve as a baseline, so that any changes can be identified in follow-up testing.
Identifying hearing loss with chemotherapy is challenging, because people have so many things to consider during the planning of treatment, and baseline hearing tests can be an afterthought. Similarly, hearing loss may not always be a symptom that people consider during therapy, so it can easily be ignored. You can ask your treating physician and oncologist the best ways to evaluate your hearing throughout the course of treatment.
If you experience any changes in your hearing or ringing in your ears at any time during your treatment, it is essential to notify your physician immediately, because it is important to get a hearing test. One of the challenges with hearing loss induced by chemotherapy is that it is often permanent. Further challenges exist because there are few useful treatment options for patients who experience hearing loss as a result of chemotherapy, so early recognition and continued monitoring is essential.
Although many efforts have been made to identify useful therapies to reverse the hearing loss, nothing is currently approved. You may be offered steroid medication if you notice hearing loss, which could offer potential benefit for some people.
Due to the permanent nature of hearing loss and few available treatment options, if you experience any symptoms of hearing loss or tinnitus during chemotherapy, it may necessitate changes in the therapy for some people, depending on many factors, including the nature of your cancer and available treatments.
Hearing loss from chemotherapy is often outside the range that impacts daily functioning of hearing; however, it is still a challenging and upsetting side effect for people receiving cancer treatment. While medication therapies aimed at reversing symptoms are limited, hearing rehabilitation with hearing aids is an option if you do experience hearing loss. Recognizing the potential for the risk of hearing loss before starting chemotherapy is essential to ensure appropriate steps are taken to monitor your hearing, adjust chemotherapy, and possibly prevent damage.
The post Chemotherapy and hearing loss: Monitoring is essential appeared first on Harvard Health Blog.