Non-Hodgkin Lymphoma, Part 2 — Possible medication side effects, restrictions, and
implications for school
Possible medication side effects
Chemotherapy may cause a variety of side effects. Some drugs effect the
bone marrow, or blood producing tissue, thus impacting blood counts. White
blood cells, hemoglobin (red blood cells that carry oxygen to other parts
of the body) or platelet cells may be affected by chemo. The result may
be increased risk of infection (if white blood cells are low), anemia
or fatigue (if red blood cells are low), or increased risk of bruising
and/or bleeding (if platelets are low). Other side effects of chemotherapy
may include :
- nausea and vomiting
- weight change
- diarrhea and constipation
- mouth sores
- fever
- pain
- temporary hair loss
- depression and anxiety
Radiation therapy may also result in side effects. Most of the side effects
of radiation go away soon after the treatment is over. However, some may
persist after treatment is complete. Nausea, fatigue, dry mouth, and skin
reactions in the treatment area are usually temporary side effects. Sometimes,
radiation therapy affects blood counts.
Physical/dietary/other restrictions
Patients with non-Hodgkin lymphoma do not have any dietary restrictions.
The disease itself does not impose physical restrictions. There may be
unique restrictions, based on the location of the non-Hodgkin lymphoma.
Consultation with the student’s parents and doctor will be necessary
to determine if there are specific restrictions for the child with non-Hodgkin
lymphoma
Implications for school
The presence of non-Hodgkin lymphoma may result in significant implications
for a child in school, and the management of non-Hodgkin lymphoma 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 non-Hodgkin lymphoma is successful at school.
The physical aspects of non-Hodgkin lymphoma must be addressed at school.
The following accommodations and adaptations may be warranted for a child
with non-Hodgkin lymphoma.
Due to the possibility of fatigue, a child with a non-Hodgkin
lymphoma 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 non-Hodgkin lymphoma by helping
to increasing muscle strength. The child with non-Hodgkin lymphoma 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 non-Hodgkin lymphoma may be
significant. Due to frequent absences, frequent infections and limitations
on physical activity, young people with non-Hodgkin lymphoma 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
non-Hodgkin lymphoma. 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, how to show compassion and other essential life lessons.
Identify strong peers to mentor the student with non-Hodgkin lymphoma
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 non-Hodgkin lymphoma 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.
Non-Hodgkin Lymphoma Part 2 — Possible medication side effects, restrictions, and implications for school
For more information, please contact:
Kathy Davis, MSEd, PhD
kdavis2@kumc.edu
(913) 588-6305