Hodgkin Disease — Part 2
Physical/dietary/other restrictions
Patients with Hodgkin disease (HD) do not have any dietary restrictions. The
disease itself does not impose physical restrictions. However, there may
be restrictions after surgery. Some patients with Hodgkin’s must
have surgery to help doctors determine what stage the disease is, in order
to identify the best possible treatment. This surgery, called a staging
laparotomy, may result in some temporary physical restrictions for a period
of time after the operation. For school-aged students, school attendance
may be interrupted for a few weeks.
Implications for school
The presence of Hodgkin disease may result in significant implications
for a child in school, and the management of Hodgkin disease at school
has several facets. Educators must consider the physical, psychosocial
and cognitive/educational issues of this diagnosis in order to ensure
that the young person with a Hodgkin disease is successful at school.
The physical aspects of Hodgkin disease must be addressed at school.
The following accommodations and adaptations may be warranted for a child
with Hodgkin disease.
- Due to the possibility of fatigue, a child with Hodgkin disease
may need to rest during the school day. It is usually best to do this
in the nurse’s office, or in a location away from the other students
in order to not increase peers’ feelings that the child is different.
- Restroom privileges should be flexible and on an “as needed”
basis.
- Exercise may benefit the child with Hodgkin disease by helping
to increasing muscle strength. The child with Hodgkin disease should be
encouraged to participate in all physical activities at school. From day
to day, the child may be limited in how much he/she can do or the duration
of time that he/she can participate in physical endeavors. There may be
times, due to steroids, that the child has difficulty with movement as
a result of weight gain and fluid retention. The child should be encouraged
to do as much as possible, and allowed to set his/her own limits for physical
activity.
- Physical stamina should be evaluated by the school nurse, and
any modifications or accommodations that are indicated should be incorporated
into the student’s IEP.
Psychosocial concerns for the student with Hodgkin disease may be significant.
Due to frequent absences, frequent infections and limitations on physical
activity, young people with Hodgkin disease struggle with issues of “fitting
in”. They may feel left out by their peers, or struggle with keeping
up socially as they flow in and out of school. In order to help facilitate
healthy psychological, emotional and social adjustment, the school should
consider:
- Educating peers, with the consent of the child and parents, about
Hodgkin disease. The hospital school teacher is a good resource for offering
a presentation, suggesting materials, or assisting with the education
of educators, peers or other interested community members.
- Encourage peers to stay in contact with their friend when he/she
is absent. Cards, letters and phone calls can serve to bridge the gap
when youngsters with chronic illnesses must be away from school and activities.
- This is a wonderful opportunity to teach peers about supporting
a friend, showing
compassion and other essential life lessons.
- Identify strong peers to mentor the student with Hodgkin disease
when he/she returns after an absence. Having someone to “fill you
in” on what you missed while hospitalized or home ill may make all
the difference in facilitating a good reentry.
- Help the student find areas of expertise and ways to excel in
the school environment. Mentoring support could be included in the IEP
to help the young person maintain or develop a strong self-concept.
- Including social work or counseling services as part of the IEP.
Having someone at school to talk to or act as an advocate for the youngster
with Hodgkin disease can be a significant asset. The student may need
the opportunity to discuss his/her fears about dying or about the future
in general, keeping up in school, socialization issues, concerns about
other family members, etc.
Hogkin, Part 2 — Restrictions and implications for school
For more information, please contact:
Kathy Davis, MSEd, PhD
kdavis2@kumc.edu
(913) 588-6305