Mrs. T, a 67 year old female, recently retired daycare teacher who was diagnosed with left (L.)breast cancer (ca) in July 2015. She felt a bump on her L. breast in July 2015 and saw her family physician. The doctor sent her for tests at the Jewish General Hospital (JGH) and she was diagnosed with L. breast cancer, PR negative(-), ER- and HER-.The patient (pt)’s first treatment at the oncology clinic took place on September 30th, 2015. She started the NSABP B56 experimental treatment protocol. The protocol states prechemotherapy, administer Ranitidine 50 milligrams(mg) intravenously (IV), diphenhydramine 50 mg IV and Dexamethasone 20 mg IV pre-Paclitaxel and Granisetron 1 mg IV pre-Carboplatin only. The chemotherapy includes study Velibarin or placebo 50 mg, study Carboplatin or placebo 612 on day one and study Paclitaxel 150 mg IV on days 1,8 and 15.As per patient, Mrs. T’s health history includes being hospitalized twice for depression over 30 years ago, gall bladder stones with surgery, appendix was removed, ”mini stroke” 2 years ago, hypertension, elevated cholesterol, fatty liver disease and sleep apnea. She has rheumatoid arthritis in her ankles, knees, neck and wrists. The patient has been a member of Alcoholics Anonymous(AA) for 20 years.
The patient is divorced and has been living independently in an apartment in
…show more content…
She has a history of depression and she reported being the “depressive type”. Pt also had a change in activities example: when she was diagnosed with breast ca, she quit her teaching job. She likes to be active and that is more challenging while undergoing chemotherapy. She also had a major change in independence level (she is now living with family and may not be able to independently care for herself and she “hates asking people for help”). The pain in her joints and bones prevented her from attending AA meeting last week, which provides her with a strong sense of