Quality of Life in Chronic Leukemia Patients

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Introduction

Many chronic diseases have continued to affect a large number of people in the current times. Leukemia is one of the most critical chronic illnesses that continue to affect many people all over the world. With the associated pain and suffering being experienced by Mohammad, our patient, there is continued hope of discovering a cure for this disease shortly. This will offer the patients a new lease in life and save a lot of resources that are utilized to provide care for the patients. With medical advancements and increased research in the best care for chronic illnesses, there is increased hope in finding a cure for these diseases. Presently, evidence-based practice and improved palliative care for chronic diseases are employed for caring for leukemia patients. Leukemia is one type of cancer, which unlike the others it doesn’t form tumors (Courtens & Abu-Saad, 1998, para.2-6). Cancer is a group of diseases in which some cells in the human body have uncontrolled growth, therefore, invading and destroying cells that are adjacent to them. They also undergo metastases which are then spread to other cells in the body through the blood or lymph. According to Merlo et al. (2006, p.925), cancers can affect anyone at any age but age is a risk factor with the old being at a higher risk. Mohammad has been diagnosed with leukemia commonly referred to as blood cancer or cancer of the bone marrow. He is experiencing malaise, excessive bruising, reduced exercise tolerance, and frequent infections, and high fever all characteristic of leukemia. With such a compromised health condition, Mohammad is unable to enjoy life fully. His quality of life is decreased in comparison to a healthy person and hence he needs palliative care to reduce the suffering associated with his conditions. A health professional team comprising various specialists like oncologists, primary health care nurses, and palliative care specialists is necessary is required to better provide the needed care (Gibbs et al., 2002, p.37). This essay discusses a case study of Mohammad who has chronic leukemia by focusing on how he lives with the disease and how he maintains his quality of life. In addition, it touches on care provision for chronic illness using a multidisciplinary approach.

Patient’s general information

Mohammad is 40 years old accountant at a local oil company. He was born and raised in Saudi Arabia where his parents are natives. At the age of 24 years, he migrated to the UK to further his education. After completion, he got employment with an oil multinational company that has a branch in the UK. Currently, he is married and together they have two children. He started developing symptoms of leukemia several years ago and was diagnosed with the disease. He has been receiving care but he migrated to another town due to a change of duty in his workstation. In his efforts to find a cure or alleviate the symptoms, this was his first attendance at this clinic.

Living with leukemia

Leukemia is a disorder of the bone marrow that occurs when an abnormal white blood cell starts to replicate itself continuously. This results in a colony of white blood cells which, unlike the normal ones, do not fight diseases and do not also die like the others (Jameson et al. 2005, p.12). Due to their increased accumulation in the body, they hinder the production of the normal blood cells in the bone marrow. This causes the associated symptoms of the chronic disease like anemia, frequent bleeding episodes which is hard to stop due to lack of platelets, and persistent infections as a result of the low immunity status of the patients (Stass, Schumacher and Rock, 2000, p.26). The abnormal cells sometimes spread in the body via the bloodstream and continue with their uncontrolled division. They may form tumors which frequently will cause the destruction of organs like the liver and the kidney. The spleen which is involved in blood-filtering and destruction of old and dying blood cells is enlarged and becomes swollen with the highly multiplied abnormal cells. Due to this Mohammad is in recurrent pain and feeling malaise and fever which greatly distracts his work. At times he experiences headaches and seizures which are often distressing. Leukemia can be grouped into four groups depending on the type of blood cell that causes it or how fast the disease progresses (Wiernik, 2001, p.10). These groups are; acute lymphocytic leukemia (ALL) which mainly affects children and is characterized by an enormous number of lymphocytes, chronic lymphocytic leukemia (CLL) which mainly affects people of higher age and is slow to progress, the chronic myelogenous leukemia (CML) which result from an abnormal translocation in chromosome 9 and 22 and is infrequent in children (Matutes, 1998, p.20). The last group is acute myeloid leukemia (AML) which involves the occurrence of a large group of immature myeloid cells that normally replaces the normal cells.

Physical impacts of leukemia on Mohammad

Continuous monitoring of Mohammad’s health condition has indicated that he suffers from frequent episodes of joint and bones pain, headaches, and sometimes confusion and seizures. Before palliative care and medication, he experienced bouts of fever and his weight was very low. According to the American Association for Clinical Chemistry, these are the signs frequently experienced by patients suffering from leukemia. However, continued care has helped him adjust to these problems although they just become minimal but never come to end. They have brought quite a distress to his life since he can not cope with his duties at the workstation due to his on and off ill health.

Psychological impacts of leukemia on Mohammad

Chronic diseases present the patients with many challenges which are lifelong and need a lot of assistance to overcome. The patient together with his or her family needs to make adjustments to cope with these diseases. Their health-seeking behavior is affected as various symptoms are ignored and frequently medical intervention is taken when it’s already too late. Many patients may not be in a position to accept their conditions as life-lasting and often results in stress which leads to depression. Mohammad reported sometimes feeling depressed especially on the episodes that he experiences great pain in joints and bones and some organs (Shives, 1998, p.23). He is also very anxious and nervous whenever he visits the hospital for checkups for fear of the results and the prognosis the doctor is going to give. At the workplace, he is reported as not being in a position to associate well with his workmates for fear of being stigmatized or being looked down upon with pity. His daily activities have been limited as a result of frequent attendance at the clinic. When Mohammad experiences painful episodes as a result of leukemia, he is forced to spend some time at the hospital with doctors having a closer observation of his condition. Consequently, he is forced to leave his family and loved ones which greatly bothers him psychologically. This in turn has influence on his quality of life. Mohammad should receive counseling sessions through the use of a multidisciplinary approach in order to reduce the anxieties and the emotional distress experienced. This will go in handy to providing proper palliative care and reduction of pain and suffering. Depression is one of the factors that lower a person’s quality of life and thus should be kept at a minimal level.

Patient’s diagnosis

When Mohammad first reported to the hospital a thorough screening was conducted to identify the type of leukemia he is suffering from and the best care he is to receive to minimize suffering. The nurse concerned obtained a clear medical history of the patient noting his past medical conditions and the present. The following tests may be used for diagnosis of leukemia; physical examination where the doctor looks out for any lymph node which may be swollen, the spleen or the liver, blood tests where blood count is conducted to find out the white blood cells count, a biopsy that involves the collection of a sample of the bone marrow where the cancerous cells are checked out (Fausel, 2007, p.11). Other types include cytogenetics where the cell’s chromosomes are checked. A biopsy was conducted on Mohammad and the results were positive for leukemia.

Treatment for leukemia

A variety of options exist for the treatment and care of leukemia. However, the option for treatment depends on the following; whether the type the patient is suffering from is chronic or is of the acute type, the age of the patient, and finally whether leukemia cells were identified in the cerebrospinal fluid of the patient. In addition, the patient’s health status is tantamount and the symptoms being experienced. According to MedicineNet (2010, p.5), chronic leukemia is hardly ever cured using chemotherapy. However, patients often receive maintenance therapies that help to keep cancer controlled. Due to the current advance in medical technology, stem cell transplants are offering hope for the treatment of leukemia. Normally, treatment is meant to cater to cell shortages and therefore push cancer into a state of dormancy (Else, Ruchlemer & Osuji, 2005, p.2443). Treatment is according to symptoms experienced and includes red blood cell transfusions, platelet transfusions, and antibiotic therapy. Mohammad experienced a lot of pain and thus was subjected to chemotherapy drugs and radiation which offered relief and killed the cancerous cells.

Self-management care

With chronic illnesses, there is a need for the patient to recognize the vital role he plays in the management of the disease. Most of the time the patient is left on his own as he makes frequent visits to the follow-up clinics. The first step involves acceptance of their condition and the willingness to comply and adhere to the treatment schedule (Morton et al., 2005, p.20). It is also important for the patient to learn how to cope with the condition by making the necessary adjustments in their life. This involves the adoption of a healthy lifestyle and working in cooperation with the health care providers. Mohammad is a good self-manager to his condition. With the help of the nurses in charge and the doctors, he has learned of the required medical services and their timely access to avoid any grave consequences. According to Bodenheimer et al. (2002, p.2470), patient empowerment is necessary to help them be in a capability to solve their problems and not rely much on health professionals. They further note that referrals should be encouraged by the physician. This helps the patient become self-efficient and thus better managers of their treatment and care. Although the patient is the biggest player in chronic illness management, it is worth noting the efforts of family members for their emotional and spiritual support and the health professionals for their medical skills. The family members of Mohammad are supportive and have helped him tackle this ailment through the provision of financial and emotional support. With such help, his quality of life is destined to improve.

Multi-disciplinary care

Palliative care is necessary for the proper management of chronic illnesses. This team normally comprises the physician, palliative care nurses, counselors, social workers, and many others. Their main duty is to provide maximum and quality care, reduce the patient’s suffering, improve the quality of life for the patients and offer support to the family (Yohannes, 2007, para.5-7). Palliative care’s main objective is the management of symptoms and ensuring improved communication between all the parties involved in caring for the patient. The physician acts as the supervisor and facilitates the caring process. The nurses offer their expertise in patient management while the counselor is there to cater to the psychological implications of leukemia. Finally, the social worker will assist Mohammad in receiving any necessary assessment during care.

Quality Of Life

The quality of life assesses the well-being of patients by evaluating the benefits of various caring interventional programs which are used or the side effects which might occur due to the application of a specified medical intervention. It is applied in various sectors and refers to the whole well-being of a person. This involves the functional capacity, social functioning, physical health, and the health perceptions of the concerned person (Moser & Worster, 2000, p.106). Patients with leukemia have been found to suffer from psychological problems due to the pain and related stressful conditions experienced. According to Health Canada (2002, p.80), to ensure the quality of end of life health care should include adequate pain and symptoms control, appropriate use of life-sustaining treatments, and sup[port for patients and their families. When this is done Mohammad will be assured high quality of life.

Conclusion

In conclusion, leukemia is among the chronic diseases affecting many people in the world. Age is a risk factor associated with it with higher occurrence in adults than in children. It has many impacts on the life of the patients as seen in the case of Mohammad. To improve care and raise the quality of life of patients, palliative care should use a multi-disciplinary approach which will ensure improved and efficient care for the patients.

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