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My Name Is NOT Cancer

Senior Occupational Therapist - Young Oncology Unit

In 2008, an Occupational Therapist post was created on the Young Oncology Unit (YOU) through a partnership between Manchester United Football Club and The Christie, called ‘United to beat Cancer’. This was the first YOU Occupational Therapist post in the country, and I was excited to get the job, as I`ve always been interested in working in cancer care!

I qualified as an Occupational Therapist in 2003 and gained valuable experience working in a variety of settings, including orthopaedics (bone conditions), stroke rehabilitation, hand therapy, and psychiatry.
Before coming to The Christie, I was an Occupational Therapist in Mental Health Services for 5 years, helping people cope with and recover from conditions such as anxiety, depression (and other psychological conditions).
The role of an Occupational Therapist is less well known compared to other professions, and I`m often asked if I`m going to get someone a job!
However the ‘Occupational’ bit of Occupational Therapy refers to the things we do to ‘occupy’ ourselves, as part of everyday life – so an OT helps people overcome different ‘challenges’ in order to continue doing what they need to or enjoy doing each day.  This can range from the activities we have to do: such as eating; drinking; having a shower; going out with friends; driving… or taking part in a favourite hobby. 
Sometimes the physical and emotional difficulties experienced by individuals when coping with an illness, can stop them from being able to do these things. It`s then the role of an Occupational Therapist to help them gain as much independence as possible, by supplying equipment (to make tasks easier) provide advice on alternative ways to do something, or help reduce the symptoms being experienced.

When I first arrived on the YOU, a lot of patients were experiencing stress and anxiety (which is normal and understandable when given a diagnosis of cancer, or coping with any treatment side effects).
My previous experience gave me greater understanding of the psychological issues surrounding stress and anxiety, and this helped me to set up an Anxiety Management Service on the unit.

It`s totally normal to feel some anxiety however, sometimes the symptoms of anxiety can be hard to cope with (such as panic attacks; or feeling that things are out of control; or that they stop you from doing the things you want to - like going out or being able to socialise with friends).
As part of my role, I offer advice on what anxiety is and suggest ways to help control the symptoms through teaching coping strategies, such as using relaxation techniques, or by looking at the way someone may be thinking about things.  Often people who are anxious or depressed become negative in their thoughts, and it can become especially difficult to look for any positives.

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I guide patients to explore different ways to express their emotions that may help them such as talking and sharing their feelings with someone, encouraging a patient to write their thoughts down in a diary, or by suggesting they take part in activities such as art, a sport, or a hobby- energy levels permitting!
Initially, I`ll complete a short questionnaire before each session (called a Hospital Anxiety and Depression Scale or ‘HADS’ for short) Basically, it`s a statement about how you may be feeling, in order to find out what you`re struggling with most, which then helps to determine how difficult any symptoms are! I repeat this questionnaire at the end of each session, to see if there`s improvement.

Within the YOU, many young people have benefitted from the Occupational Therapist Anxiety Management Service, stating that it really helped them reduce their anxiety levels.  They found it useful to talk to someone who understands how they`re feeling… and by learning to deal with their symptoms, Occupational Therapy helped them feel a sense of control again! Some of my patients on the YOU have helped to create a DVD accessible on the jimmyteenstv website (search for ‘anxiety’ or follow this link) which describes their experiences and how Occupational Therapy has helped!

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I`m lucky to be able to see people on the YOU or in their own home - whichever they feel most comfortable with.
I am part of the ‘Family Support Network’ and run groups to provide information and support on coping with stress and anxiety to relatives, partners and friends.
I`ve also been involved in the ‘Survivors of Cancer’ group (SOC) for patients who`ve finished treatment, and within SOC, I`ve led relaxation sessions and given advice on coping with stress. 
Often, people will contact me after they`ve finished treatment, as is can sometimes be hard getting back to normal and thinking back over their cancer experience!
If an individual has more complicated symptoms or a long term psychological condition, I refer them (with the person’s permission) to the Psycho-Oncology service at The Christie, which offers more support through a counselling service and access to psychiatrist and psychologist support.

On a practical level, a large part of my job is helping to overcome the physical difficulties people may have due to their cancer diagnosis.  My patients have described extreme fatigue (tiredness) as one of the worst side effects experienced due to chemotherapy or radiotherapy.
As an Occupational Therapist, I give advice on how to change ways of doing something, for example: sometimes people choose to use a wheelchair so they can still go out if they`re struggling to walk long distances, and in this situation, the person may need ideas on pacing, planning tasks, and prioritising what`s important!
I complete home visits to assess if any adaptations or extra help is needed at home (such as ramps, equipment to help with getting in the bath or shower, or rails to help on the stairs, etc)
I sometimes arrange for a bed downstairs if it`s difficult for a patient to get upstairs… and I can link in with Social Services if advice is needed on moving to a different property, or if needing extra help, such as Carers at Home.
Coping with physical difficulties in order to be able to do the things you want is important to help retain identity. Learning to drive, returning to studies/work, or managing a family all take energy and contribute to fatigue. This is where the OT steps in!

My colleagues on the YOU (the Youth Support Worker and Play Specialist) regularly organise groups and activities as part of a ward programme, which include Complementary Therapy, Music, Art Therapy, and VLG (Volunteer Led Groups).  I also run group sessions and we bake and make pizza!  These sessions help increase confidence and self esteem, by achieving something whilst at the same time, distracting from the physical side effects of treatment.
Working as a group, gives an emotional ‘boost’ to overcome difficulties (such as feeling down or anxious) and by bringing patients together to talk about their experiences, they cope better with side effects such as hair loss and body changes.

In the hospital, we have access to an Occupational Therapy kitchen that patients can use with the therapist. Patients come to the kitchen to cook their own lunch or tea and really enjoy having time in a different environment… it helps them to feel more independent and sessions are focused on completing an activity!
The role of the Occupational Therapist is important throughout the cancer journey: from diagnosis, through treatment and after treatment has finished.  My goal is to enable people to be able to live as normal life as possible and be able to do the things they want in life.

It`s important that every person who comes through the unit is seen as an individual, and I like finding out what interests that person and how they`d normally occupy their time.
I believe every unit across the country should have an Occupational Therapist and due to the unique nature of my post at the Christie, I`m involved in educating others about the benefits of OT involvement in patient care, and have attended and presented at a variety of conferences about my role.
To me, it`s crucial that patients on the YOU get the best experience possible! The diverse nature of my role allows the time I spend with each individual person, to be specific and meaningful to them, allowing them the opportunity to set their own goals and aims. 
I work alongside many other professionals on the unit and together, we help people get through a very difficult time!

I think I`m a positive person, and I try to bring that positivity into the time I spend with patients.
I am privileged to work in my role as an Occupational Therapist, with the inspiring young people I meet on a daily basis.

By Anna Mann - Senior Occupational Therapist, Young Oncology Unit, The Christie.

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