Personal Calendar Tracker

Transcription

1 Personal Calendar Tracker

2 The Personal Calendar Tracker was created as a companion to the Patient and Family Reference Handbook, which was developed for people living with kidney cancer and their families. Please use this resource to keep track of appointments and contacts, but most importantly, to regularly monitor your vital health information. If you take it with you to your doctors appointments, your healthcare team can use the information you ve recorded as a guide for setting future healthcare goals. Note: The information provided in this Personal Calendar Tracker is for general use only and is not a substitute for professional medical advice regarding your health or the medication(s) and treatments you have been prescribed. If you have questions, please contact your doctor.

3 Contents Personal Information Frequently Contacted Healthcare Professionals Additional Healthcare Professionals Other Important Contacts Appointments At A Glance Prescription Medications 9 Over-The-Counter Medications 10 Potential Side Effects 11 Side Effect Tracker 1 Tests And Treatments 1 Blood Test Tracker 1 Blood Pressure Tracker 1 Physical Activity Tracker 1 Keeping Track Of Your Diet During Treatment 19 Questions For My Doctor 1 Year At A Glance & Monthly Tracker

4 This Personal Calendar Tracker belongs to: If found, please call: Frequently Contacted Healthcare Professionals Family Physician Name Address Telephone Medical Oncologist Name Address Telephone Urologist Name Address Telephone

5 Frequently Contacted Healthcare Professionals Oncology Clinic Name Address Telephone Imaging Name Address Telephone Pharmacist Name Address Telephone Nurse Name Address Telephone

6 Additional Healthcare Professionals Name Role Address Telephone Name Role Address Telephone Name Role Address Telephone Name Role Address Telephone Name Role Address Telephone

7 Other Important Contacts Name Role Address Telephone Name Role Address Telephone Name Role Address Telephone Name Role Address Telephone Name Role Address Telephone

8 Appointments At A Glance Dates Name of Healthcare Professional Location /Follow-up Appointments

9 Appointments At A Glance Dates Name of Healthcare Professional Location /Follow-up Appointments

10 Appointments At A Glance Dates Name of Healthcare Professional Location /Follow-up Appointments

11 Prescription Medications Use this chart to keep track of the prescription medications you re currently taking (medicines that have been prescribed by your doctor). On the next page, there is a place to record all over-the-counter medications that you re taking. Medication Name Reason (kidney cancer, blood pressure, heart, etc.) Starting Dose How to Take It Starting Date Ending Date 9

12 Over-The-Counter Medications Use this chart to keep track of all over-the-counter medications you re currently taking, including herbal remedies, vitamins, laxatives, eye drops and minerals. Medication Name Starting Dose How to Take It Starting Date Ending Date Drug interactions can contribute to many potentially serious side effects. That s why it s so important to tell your doctor about ALL the medications you re taking 10 including herbal remedies, laxatives, vitamins and supplements.

13 Potential Side Effects Regardless of the therapy you are receiving to treat your kidney cancer, there are a number of potential side effects that you may experience during your treatment. The following side effects are sometimes experienced by patients receiving certain types of treatment for kidney cancer: Increased blood pressure Tiredness (fatigue) Low white blood cell count (neutropenia) Low platelets (thrombocytopenia) Low red blood cell count (anemia) Upset stomach, nausea or vomiting Loss of appetite or taste disturbances Mouth irritation Constipation or diarrhea Skin or hair discolouration Hand-foot syndrome (rash or blisters on the palms of the hands and soles of the feet) Headache 11

14 Side Effect Tracker Use the chart below to keep track of any side effects you experience so you can discuss them with your healthcare team. Side Effect (SE) Severity (1 to 10) Date Doctor s Instructions If you develop a side effect, it is essential that you discuss it right away with your healthcare team so that it can be managed quickly and appropriately and so that it is reported to Health Canada and/or the drug manufacturer. STOP taking your kidney cancer medication and call your doctor or pharmacist if you experience: - symptoms of a possible heart rhythm disturbance, such as dizziness, palpitations (sensation of rapid, pounding or irregular heartbeat), fainting or seizures. - symptoms of brain swelling that can be associated with high blood pressure, headache, loss of speech or vision and/or seizures. - swelling or difficulty breathing suggestive of an allergic reaction (hypersensitivity/ infusion) reaction. - severe bleeding in the digestive tract (stomach and intestine) or lung. 1 - yellowing of the skin or eyes.

15 Tests And Treatments Use the chart below to keep track of any tests or treatments your healthcare team asks you to undergo (e.g., cardiac or thyroid tests, CT or MRI scans, radiation therapy, etc.). To record blood test results, use the convenient Blood Test Tracker that is provided on the following page. Date Test or Treatment Received Doctor s Name and Instructions Results/Follow-up 1

16 Blood Test Tracker While you are receiving treatment for cancer, your healthcare team will perform regular blood tests to monitor your progress. Common blood tests can determine if you have: a low number of white blood cells (neutropenia), low red blood cells (anemia), low platelets (thrombocytopenia) or other important conditions. Use the chart below to record the results of these tests. Date Blood Test Performed Test Result Doctor s Name and Instructions 1

17 Blood Pressure Tracker Your healthcare team may ask you to take your blood pressure on a regular (or daily) basis and record the results. Use the chart below to keep track of your blood pressure readings and compare them to the target that your doctor has set for you. My doctor has determined that for me, a normal blood pressure range is: Systolic (top number) of to. Diastolic (bottom number) of to. Date Time of Day Systolic Reading (mmhg) Diastolic Reading (mmhg) 1

18 Date Time of Day Systolic Reading (mmhg) Diastolic Reading (mmhg) 1

19 Physical Activity Tracker Use these pages to keep track of your goals and the physical activities you perform each day. Before starting on any exercise program, you MUST check with your healthcare team to establish a level of activity that is safe and beneficial for you. Have your planned activity program approved by your healthcare team and reviewed periodically. Following a thorough assessment of my health and fitness, my healthcare team has determined that these activity goals are appropriate for me: Short-term goals Long-term goals 1

20 Record of Daily Physical Activity: Date Activity 1

21 Keeping Track Of Your Diet During Treatment Eating a healthy diet while managing the side effects of treatment can sometimes be a challenge. Use these pages to record the types of foods you have found work well for your particular circumstances. During cancer treatment, it is a good idea to seek the advice of a qualified dietician one who has experience with cancer management to help you set goals and guide your nutritional choices. What are your dietary goals? (e.g., gain weight, manage nausea, increase fluids, limit protein, heal mouth sores, etc.) 19

22 Type of Food Effects 0

23 Questions For My Doctor Make note of any non-urgent questions as you think of them, so that you ll remember to discuss them with your doctor at your next appointment. 1

24 Year At A Glance & Monthly Tracker Use the pages that follow to keep track of your appointments and to record when you have taken your medications each day. Fill in the month and the dates in the spaces provided. Using the legend, enter any appointments or other consultations your healthcare team has scheduled for you. Year At A Glance & Monthly Tracker

25 01 Year At A Glance January February March April sun mon tue wed thu fri sat sun mon tue wed thu fri sat sun mon tue wed thu fri sat sun mon tue wed thu fri sat May June July August sun mon tue wed thu fri sat sun mon tue wed thu fri sat sun mon tue wed thu fri sat sun mon tue wed thu fri sat September October November December sun mon tue wed thu fri sat sun mon tue wed thu fri sat sun mon tue wed thu fri sat sun mon tue wed thu fri sat Visit the Resources section at to download printable calendars for other years.

26 C R T Legend Chemotherapy Radiotherapy Tests Month: January 01 Mon Tues Wed Thur Fri Sat Sun 1 1 E Exams/Scans U O Urologist Oncologist D Dietician SW PSYCH Social Worker Psychologist

27 C R T Legend Chemotherapy Radiotherapy Tests Month: February 01 Mon Tues Wed Thur Fri Sat Sun E Exams/Scans U O Urologist Oncologist 9 10 D Dietician SW PSYCH Social Worker Psychologist

28 C R T Legend Chemotherapy Radiotherapy Tests Month: March 01 Mon Tues Wed Thur Fri Sat Sun 1 E Exams/Scans U O Urologist Oncologist 9 10 D Dietician SW PSYCH Social Worker Psychologist

29 C R T Legend Chemotherapy Radiotherapy Tests Month: April 01 Mon Tues Wed Thur Fri Sat Sun 1 E Exams/Scans U O Urologist Oncologist D Dietician SW PSYCH Social Worker Psychologist

30 C R T Legend Chemotherapy Radiotherapy Tests Month: May 01 Mon Tues Wed Thur Fri Sat Sun E Exams/Scans U O Urologist Oncologist D Dietician SW PSYCH Social Worker Psychologist

31 C Legend Chemotherapy Month: June 01 R T Radiotherapy Tests Mon Tues Wed Thur Fri Sat Sun E Exams/Scans U O Urologist Oncologist 9 D Dietician SW PSYCH Social Worker Psychologist

32 C R T Legend Chemotherapy Radiotherapy Tests Month: July 01 Mon Tues Wed Thur Fri Sat Sun 1 E Exams/Scans U O Urologist Oncologist D Dietician SW PSYCH Social Worker Psychologist

33 C Legend Chemotherapy Month: August 01 R T Radiotherapy Tests Mon Tues Wed Thur Fri Sat Sun E Exams/Scans U O Urologist Oncologist D Dietician SW PSYCH Social Worker Psychologist

34 C R T Legend Chemotherapy Radiotherapy Tests Month: September 01 Mon Tues Wed Thur Fri Sat Sun E Exams/Scans U O Urologist Oncologist D Dietician SW PSYCH Social Worker Psychologist

35 C Legend Chemotherapy Month: October 01 R T Radiotherapy Tests Mon Tues Wed Thur Fri Sat Sun 1 1 E Exams/Scans U O Urologist Oncologist D Dietician SW PSYCH Social Worker Psychologist

36 C R T Legend Chemotherapy Radiotherapy Tests Month: November 01 Mon Tues Wed Thur Fri Sat Sun E Exams/Scans U O Urologist Oncologist 9 10 D Dietician SW PSYCH Social Worker Psychologist

37 C Legend Chemotherapy Month: December 01 R T Radiotherapy Tests Mon Tues Wed Thur Fri Sat Sun E Exams/Scans U O Urologist Oncologist D Dietician SW PSYCH Social Worker Psychologist

38 Kidney Cancer Canada Toll Free: This Personal Calendar Tracker was prepared in collaboration with Kidney Cancer Canada, a patient-led support organization with the purpose of improving the quality of life of patients and families who are living with kidney cancer. 01 Pfizer Canada Inc. Kirkland, Quebec H9J M CA011SUT001E This Personal Calendar Tracker was supported by Pfizer Canada.