Question

A patient who had a supraglottic partial laryngectomy with a right sided radical neck dissection 4 weeks ago is now receiving radiation therapy. He has lost 24 pounds since his surgery, which makes him 15 pounds less than his ideal weight. He tells you that he has no appetite and that what food he does eat “has no taste”. In addition although he expresses that he is glad to be alive he does not want friends to visit because it takes so much energy to interact with them. He also says that he can no longer play the piano because of difficulty moving his right arm and shoulder. What factors are contributing to his fatigue? Is the weight loss a concern? If so, what should you do about it? Should you further press the issue of not wanting to visit with friends? Why or why not? What other health care professionals or resources would be appropriate at this time?

Answer 1

1). What factors are contributing to his fatigue?

Radiation therapy and loss of appetite

2). Is the weight loss a concern? If so, what should you do about it?

People who go through radiation and chemotherapy have higher demand for nutrients as more nutrients and energy are needed to meet the metabolic demands due to healing process. So, his less body weight is of much concern. One should consider the nutritionist (to plan a diet) and consider taking the food supplements.

3). you further press the issue of not wanting to visit with friends? Why or why not?

Pressing him to meet his friends is not good and not necessary. However, the patient may feel like meeting them again once he recover

4). What other health care professionals or resources would be appropriate at this time?

Occupational therapist (to improve the muscle tone), and a pathologist who deals with speech and language (can teach communicating methods that demand less energy). Communicating with the other patients who undergone the same type of surgery will also most helpful.