Chapter 12 E-materials

Author profiles

Kate Baker BSc(Hons) MCSP

Kate qualified from Nottingham University School of Physiotherapy in 2003. After completing her junior rotations in Cardiff she worked as a senior physiotherapist in respiratory until the opportunity arose to apply for a full time position at Cardiff’s regional cancer centre, Velindre Hospital. It was here she specialised in oncology and palliative care and she now currently leads the physiotherapy inpatient and outpatient team. Her areas of specialism lie in breast, head and neck cancers.

Kate is an executive member of the Association of Chartered Physiotherapists in Oncology and Palliative Care (ACPOPC) and is currently the treasurer. She has recently completed her foundation in acupuncture course and is enjoying the challenges and opportunities that this has brought.

Karen Livingstone GradDipPhys MCSP

Karen Livingstone is a clinical specialist physiotherapist working in Oncology and Palliative care for both St Ann’s Hospice, Manchester, and the University Hospital of South Manchester.

She has extensive experience with over 14 years in rehabilitation in the cancer field and has been involved locally and nationally in lecturing and education. A published author in several book chapters she also is participating in national research in exercise, lymphoedema and breast cancer and was runner up in the Princes Trust Integrated Health Awards for Fatigue Management in Cancer care.

Aileen McCartney MSc BSc(Hons) MCSP

Aileen is a specialist physiotherapist working at the Wisdom Hospice in Rochester, Kent. Aileen has been working in specialist palliative care for 5 years. She completed her MSc in Supportive and Palliative Care in 2010 focusing on rehabilitation for primary brain tumours. The results of her dissertation were published in Palliative Medicine in 2011.

Aileen is currently the education and research officer for the Association of Chartered Physiotherapists in Oncology and Palliative Care.

Siobhan O’Mahony PG Dip Health Services Management GradDipPhys MCSP

Siobhan O’Mahony qualified from the New University of Ulster at Jordanstown, Belfast in 1982. Having spent three and a half years rotating through the specialities as a junior physiotherapist, in the Royal Victoria Hospital, Belfast, she moved to Cork in 1986, and was appointed to the position of senior physiotherapist in neurology and rehabilitation in Cork University Hospital.

In 1991, she took up a position at the Mercy Hospital, Cork, leaving in January 1998 to set up a new specialist palliative care physiotherapy service at Marymount Hospice in Cork, where she is currently the physiotherapy manager.

In 2004, she completed a post-graduate diploma in Health Services Management at the University of Limerick.

Having been a member of the Association of Chartered Physiotherapists in Oncology and Palliative Care (ACPOPC) since 1998, she joined the Executive Committee in 2007, and is currently the secretary.

Appendix 12.1 Normal blood values

Haematology

• Platelet count – normal range 150–00 × 10⁹/L

• White blood cell count (WBC) – normal range 4–11 × 10⁹/L

– Basophil granulocytes – normal range <0.01–0.1 × 10⁹/L

– Eosinophil granulocytes – normal range 0.04–0.4 × 10⁹/L

– Lymphocytes – normal range 1.5–4.0 × 10⁹/L

– Monocytes – normal range 0.2–0.8 × 10⁹/L

– Neutrophil granulocytes – normal range 2.0–7.5 × 10⁹/L

Biochemistry

• Potassium – normal range 3.5–5.0 mmol/L

• Sodium – normal range 135–146 mmol/L

• Urea – normal range 2.5–6.7 mmol/L/normal range 8–25 mg/dL

• Phosphate – normal range 0.8–1.5 mmol/L

Adapted from Kumar & Clark 2002.

Appendix 12.2 Red and yellow flags

Yellow flags	Red flags
Yellow flags are pyschosocial factors shown to be indicative of long-term chronicity and disability Negative coping strategies Poor self-efficacy beliefs Fear-avoidance behaviour Distress Attitude that back pain is harmful or potentially severely disabling Reduced activity levels An expectation that passive, rather than active, treatment will be beneficial A tendency to depression, low morale, and social withdrawalSocial or financial problems	Red flags are possible indicators of serious spinal pathology, urgent medical advice should be sought Constant pain, day and night Multiple nerve root pain Progressive neurological deficit Bladder or bowel dysfunction Reduced anal tone, saddle anaesthesia Unexplained weight loss Use of systemic steroids Thoracic pain Fever History of carcinoma Age of onset <20 years or >55 years Ill health or presence of other medical illness Disturbed gait

Yellow flags

Red flags

Yellow flags are pyschosocial factors shown to be indicative of long-term chronicity and disability
Negative coping strategies
Poor self-efficacy beliefs
Fear-avoidance behaviour
Distress
Attitude that back pain is harmful or potentially severely disabling
Reduced activity levels
An expectation that passive, rather than active, treatment will be beneficial
A tendency to depression, low morale, and social withdrawalSocial or financial problems

Red flags are possible indicators of serious spinal pathology, urgent medical advice should be sought
Constant pain, day and night
Multiple nerve root pain
Progressive neurological deficit
Bladder or bowel dysfunction
Reduced anal tone, saddle anaesthesia
Unexplained weight loss
Use of systemic steroids
Thoracic pain
Fever
History of carcinoma
Age of onset <20 years or >55 years
Ill health or presence of other medical illness
Disturbed gait

Reproduced from Samata J, Kendall J, Samanta A 2003 Chronic low back pain. British Medical Journal 326:535, with permission from BMJ Publishing Group Ltd.