Discharge Instructions for Non-Hodgkin Lymphoma

You have been diagnosed with non-Hodgkin lymphoma (NHL). Lymphoma is a type of cancer that starts in your body’s lymphatic (lymph) system. The lymph system is part of your immune system. It helps you fight disease and infection. This system goes to every part of your body. Because of this, non-Hodgkin lymphoma can spread to many places in your body. Treatment may include chemotherapy, radiation therapy, immunotherapy, and targeted therapy. In some cases, it may include a stem cell transplant. Here’s what you need to know about caring for yourself during and after treatment.

General guidelines

Be sure to follow any instructions you get from your healthcare provider. Make sure you:

• Take all medicines as instructed.

• Understand what you can and can’t do.

• Balance rest with activity. Take naps during the day, if you are tired. But try to move around and walk as much as possible.

• Keep your follow-up appointments.

• Know how to reach your healthcare provider's office after office hours and on weekends and holidays.

• Call your healthcare provider if you have any questions or are concerned about any symptoms.

Preventing and treating mouth sores

Many people get mouth sores during chemotherapy. Here’s what you can do to help with them:

• Brush your teeth with a soft-bristle toothbrush after every meal. If your gums bleed while brushing, try sponge brushes or liquid dental rinse or cleansers.

• Don’t use dental floss if you are at higher risk for bleeding. You have this risk if you have a low platelet count.

• Use any mouthwashes or rinses as instructed.

• If you can’t brush your teeth or use mouthwash, ask your provider about other ways to keep your mouth clean.

• Check your mouth and tongue for white patches. This may be a sign of a yeast infection (thrush). This is a common side effect of chemotherapy. Be sure to tell your healthcare provider. Medicine can help.

• Eat soft, bland, moist foods that are easy to swallow. Chilled or cool foods may feel better than hot food.

• Don't drink alcohol or soda.

• Don't use tobacco.

• Stay away from spicy, acidic, and hard, dry foods.

Managing other side effects

• Let your healthcare provider know if you have a sore throat or mouth pain. It may mean you have an infection. You may need medicine.

• You may get sunburn-like skin changes from radiation treatment. Let your healthcare provider know. There are creams to help lessen mild pain, improve healing, and protect your skin.

• Bathe or shower regularly to keep clean. Use warm water and mild soap. During treatment, your body is not able to fight infections very well.

• Treatment can make your skin dry. Ask your healthcare team what moisturizers are OK to use, especially if you're getting radiation.

You may have an upset stomach or vomiting during treatment. You may lose your appetite. Let your healthcare provider know. There are medicines that can help. Try to:

• Eat small amounts of food many times during the day

• Include some of your favorite foods in your diet

• Make sure you drink lots of water and other healthy drinks

• Eat soft, plain foods. For instance, try pudding, apple sauce, gelatin, ice cream, sherbet, yogurt, or milkshakes.

• Make sure you cook all food well and store all food safely. This helps to prevent illness from food.

The side effects you should watch for depend on the type of treatment you get. Ask your treatment team:

• What you can expect

• What you can do to help prevent side effects

• What you should do about changes or problems

• When you should call them

Follow-up care

Follow up as instructed by your healthcare provider. Keep all your follow-up appointments. You'll need to have scans and tests to watch for side effects and signs of cancer coming back for a long time after treatment ends.

When to call your healthcare provider

Talk to your healthcare provider about what problems you should watch for. Call right away if you have any of these:

• Fever of 100.4°F (38°C) or higher, or as directed by your healthcare provider

• Shaking chills

• Signs of an infection, such as an area with redness, pain, swelling, or warmth

• New cough, or coughing up yellow or green mucus

• Sore throat, mouth pain, or white patches inside your mouth

• Wheezing or shortness of breath

• Unusual or excessive bleeding

• Headache, confusion, trouble focusing, or memory loss

• Feeling dizzy or lightheaded

• Fast or irregular heartbeat

• Rash or itchy, raised, red areas on your skin, called hives

• Yellowish skin or whites of the eyes, called jaundice

• New lumps under your arms, on or near your neck, or on or near your groin

• Pain that doesn't get better or keeps getting worse

• New swelling, warmth, pain, or redness in an arm or leg

• Nausea, vomiting, or diarrhea that doesn't get better

• Trouble passing urine or changes in how your urine looks or smells