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You’re listening to the Cornwall Cancer Cafe podcast. With me, Matthew. And me, Emma. Thanks
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to the National Lottery Community Fund for supporting this podcast. So we are back with
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Dr. Becky Hopkins and just remind us of your role, first of all, because you’ve got a dual
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role in this, haven’t you? That’s right, Matthew. So I’m a GP in St Agnes and that’s
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of my week. I’m also a clinical non-executive director at Royal Cornwall Hospital as well.
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So I’m on the board for that and I help to provide a GP and neighbourhood perspective
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to the hospital. So a very broad sort of, you cover a wide range of areas that are
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often there. So which is really important, isn’t it, Emma? It is really important. We’ve
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sort of really been focusing on the GP side of things and I’d like to ask you a few more
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questions about your GP practice and GPs and the practice as a whole, if that’s okay.
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So in a previous podcast, we talked about having that second pair of ears. So obviously
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you’ve got the cancer patient, but the cancer patient needs support. And where you’ve got
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family and friends providing that support, when they come to see you with the patient,
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you know, what support can you give them? And also if they may come to see you
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about the patient and how do you deal with that side of things as well?
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Thanks very much, Emma. So yeah, absolutely. It’s really important that we kind of both
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recognise and support carers for people. They do a lot for the patient and they often will do
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with unpaid or with little recognition. And I think that’s, you know, it’s really important
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that we kind of supporting everybody. So supporting the patient and the carers as
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well. And often the carers are patients within the practice most of the time as well. So
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that’s really important. We’ve got carers who are sort of family members or loved ones
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and we’ve got neighbours that sometimes become carers. And certainly I see a lot of that kind of
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support within Cornwall specifically, as opposed to previous city living. And you
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really see the benefit of kind of community down here. And also then we’ve got sort of
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paid carers who have a kind of slightly different role as well. And so it’s kind of
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looking at all of it together. And carers themselves may have specific needs themselves.
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They may well have their own health needs to be dealt with. And we will certainly be,
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if there are patients, we’ll be dealing with those. But also addressing kind of any stress
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or psychological aspects for them. And looking at just generally the whole kind of social
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setup for both the carer and their family. Some of them obviously live together. Some of them
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will be living separately. And everyone’s got their own lives and their own things,
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the stresses or joys and stresses that happen within their own lives as well.
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We’re all people at the end of the day. So it’s kind of recognising that. And I think
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something even simple but powerful is, and how are you? And that’s really important from a
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to go, oh gosh, wow, they’ve asked me about me. Because we’re here dealing with the patient with
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the cancer or with any other condition. And so that can sometimes go a long way in terms
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of just sort of listening and just asking about them. And that’s really important.
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Yeah, I think as a person dealing with cancer and going through it, you sometimes don’t
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appreciate or you don’t know, you don’t understand how your carers, your family, your friends,
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the people that are there running around after you, driving you around. These are all your
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carers. The people that come into your life to support you. These are your carers. And the
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ones that come to your medical appointments with you as well, they’re your carers.
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So I suppose as a cancer patient, you don’t always recognise that these people have their
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issues because you’re so focused on yourself. And of course you need to be because you want
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to get better. So yeah, getting that extra support from your GP practice for your carers
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is so, so important. So I mentioned about if the carer wants to come to the GP to talk about
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you, how does that work? So it’s a really, really important
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point. And what I would say is that confidentiality is really, really important to all
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doctors. And we have a Hippocratic oath that we declare, and we’re also abide by the General
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Medical Council regulations on confidentiality as well. So it is incredibly important.
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And so what we would normally do in that situation is we’d recommend that
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we have the permission of the person before we speak to them. And sometimes I will phone
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people up and say, I’ve got somebody who wants to talk with the permission of the person,
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the carer. I’ll say, look, we’ve got somebody here who can I release that information,
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medical information to them. So that’s important. What I would encourage people to
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do is to speak to, if a carer is coming in about a patient, is to say that they’re coming
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in to the patient to say, I’m coming in to talk about some problems that you’ve got,
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such as your pain or something else that’s going on. And that works well in the majority
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of cases, but it doesn’t always work because the carers themselves may not want to say that
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to the patient, in which case then we can listen and hear what the concerns are,
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but we can’t then share information with the carer. So there’s ways to kind of
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find the information about the concerns and other things and then kind of go from there.
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But I would try as much as possible that everybody’s open and on the same page with
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so that we can kind of all share it together. But it can be quite tricky and it’s something
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that we do come across from time to time. But also the confidentiality of the patient is
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really very important. One thing that can be very helpful is if we’ve got kind of written
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permission from the patient to be able to discuss elements of person’s care in the records.
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And that’s really helpful because if we’ve got, I give permission to share that medical
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information with my carer, the named person, and they signed it and dated it, then that’s
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great. And they can specify exactly what parts of their care they would like to discuss.
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So it doesn’t necessarily mean that they’re going to be discussing all of the medical things
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with them. And even from X date to this date even. So that’s really very important that
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we need that permission to discuss things further.
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Is that a form that GP surgeries have or does someone just need to write a general letter?
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A simple letter with the patient’s name and signature on and date is all that’s needed.
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Here to support you, the Cornwall Cancer Cafe podcast.
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Visit our website www.cancercafe.org.
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When I was in treatment, my key supporter was my mother. Now my mother’s 85. And I didn’t want
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to overly worry her. And I could see that she didn’t want to overly worry me. And there
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is a sort of a bit of a tension there. There can be a tension there. And if we know
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more about those tensions and your feelings around it, we will obviously be able to
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respect that. And so that’s really important. And everyone will be different. They’ll be
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different with their relationships. They’ll be different with all sorts of things around
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what they’d like to share and what they wouldn’t like to share. So that’s one side
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of it. And I think the other side of it is supporting the carers in what they’re going
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through as well. And so there’s a whole host of things that we can do to kind of support
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the carer in what their needs are as well really. So things such as whatever their
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symptoms are, whatever their, any of the long-term conditions, because their health
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sometimes goes a little bit out of the window as well as they put people first.
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Well, they’re having to sort of lift them into chairs, wheelchairs sometimes and
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needs changes to the home. Yeah, sometimes it’s emotional support. And there’s the mental
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side of it as well, trying to stay positive, trying to say the right thing. It must be a
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struggle. It must be. Well, I’m saying it must be a struggle because I think we can also put
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we’ve sort of been in the carer’s position because we’ve been in the cancer
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family, if you like, for a little while. We’ve met other people that have got cancer,
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are living with cancer, are in treatment. So we’ve also sort of been carers for other
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people, not as close as our family and friends have been to us. So I think there’s
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a language as well that is learned. Yes. Well, one of the things that comes to
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mind is another thing that came to mind is I was watching a Finnish film, you know,
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subtitles the other day. And it was called Hope. And I don’t know if you’ve seen this
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film. It’s about a lady who gets diagnosed with cancer. She has a partner, a long-term
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partner. She has children with him and he has his own children. And it’s all about
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really not so much the cancer, but the stress that it puts on a relationship. And
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at one point, this man says to his partner who he actually marries when he finds that she’s
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got a few months to live. But at one point he says, you’re ruthless, you are.
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It’s very difficult, isn’t it? There’s a lot of emotions going on and a lot of things that
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need support. And so I think it’s really important that carers have some time to
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themselves as well. And there are things such as in the cove, for example, where there are
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specific groups for carer support or for families support, both younger and older
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people as well. So all of those things are really important. And it’s all about
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wellbeing, isn’t it? And it’s a stressful time. It’s a stressful situation for everybody.
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It’s a big part of people’s lives and will be part of what they do every day.
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And so all of those things are really very important. And the more support that we can
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give them, both in general practice, also the bigger primary care teams such as
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the social prescribers can be very important in that time to help support carers.
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And then also the voluntary sector as well as the support services at the cove
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and Macmillan. So there’s a whole host of things. And of course there’s financial things
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as well, such as getting attendance allowance as well. And we are really very aware of that
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within primary care. And we want to try and support people as much as possible,
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looking at both the patient themselves, but the people around them as well.
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So if your cancer patient is noticing that their carers need some help and they come to
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and say, my partner’s really struggling, how would you reach out to them?
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There’s different ways that we could reach out to them. What I would always encourage the
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person to do is to kind of be open with them and say, I went to the GP today because
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I was a bit worried about how you’re managing at the moment, or that you seemed a bit
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more stressed recently or that side of things. And I will often offer an appointment for
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them and say that’s what I’d encourage the person to do is to kind of bridge that gap
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in terms of that they’re worried about it and that they need help with that.
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If they don’t feel able to do that, we might be able to invite somebody in for a review
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if they’re our patient. If they’re not our patient, then we’d encourage them to
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seek help through their own healthcare professional. There’s different ways around
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it to help support people. But I would try and encourage people to have that open and
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honest conversation with their loved one or their carer about it. If there are specific
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safeguarding issues, then that’s a different matter.
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What we haven’t mentioned at all is about the care for say a teenager or a child and
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what happens there because parents are acting as carers for say a child with cancer.
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It’s very very challenging and I think the support that we give to parents in that
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situation has got to be sort of huge really. It must be absolutely terrible to be in that
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kind of situation and so the more support that we can give to the whole families
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is very important. I suppose with families it can lead to break up if it’s not handled
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very sensitively. You do hear about partners or even married couples who can’t cope.
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It can do that. It can also bring people together because they’re having to work more
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as a team and really consider everybody. So it can go either way and I think it’s
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supporting them and knowing that actually there are other services that they could
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go to to kind of help with their relationships such as Relate for example.
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So there’s a whole host of things out there for people to help support their relationships.
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And I don’t know if any of the drugs you had during treatment changed how you reacted
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to things. I mean I had some steroids which particularly made me very emotional and I’m sure
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it changed how I reacted to it all sort of tears and things and that I haven’t really discussed
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with my mother how she coped with me in that phase but I mean that is something the drugs
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can change that. Absolutely and I’ve got some quite funny stories that I can’t share on this
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podcast about people who’ve been on steroids and but you do have to see the kind of
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hearted bits about it as well and so you know we kind of we do often have quite a few giggles in
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consultations in often times when there’s quite serious things to discuss but actually there’s
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always a an element of humor around situations as well. But I do tend to warn people
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particularly and I’m sure that other doctors will as well about some of the potential side
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side effects and steroids in particular it can do so just say to people be careful you
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might feel a bit happy on these or be careful with your credit cards in this time so things
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like that. Just to reassure listeners that might be going on steroids or on steroids at
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the moment that they are there for a very good reason and majority of people don’t have
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side effects but it’s just a small chance. I definitely did have those but my emotions
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flip-flop between being very tearful to being very angry. Yes and that can happen with a lot
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of treatments but also you’re going through a big thing as well in terms of you’re
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adapting to your diagnosis and your life changing as well. So people will go through those
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different phases denial anger you know sort of sadness and acceptance and they won’t go
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through on a linear line won’t go through straight away either they’ll go chop and
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change between those things as as they’re coping. Yeah I think I just tried to put a
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you’re looking well or you’re really brave you’re coping with it really well and I sent you a mean
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didn’t I the other day and it was I can’t remember the exact words of it and it was
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something like you know on the outside I look like I’m I’m doing really well but on the
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inside I’m having an absolute breakdown and crying etc etc. Yeah absolutely and you know
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everyone copes with things in different ways and that will have been through how they
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have learned as a child and who they are as a person as well and what I would say is that
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you know it’s absolutely however you’re coping with it is very tailored to yourself.
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If you are struggling if you’re able to sort of able to open up a little bit to to your GP
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or to someone going to come you know on the outside I look like I’m doing all right but
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actually I’m a little bit crumbling inside that then kind of helps us to kind of understand
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everyone reacts to things in lots of different ways and there’s no there’s nothing wrong with
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with that it’s about kind of tailoring how we deal with supporting you in in that time so all
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of those things are important and something that I thought was quite a good thing was you know
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it’s learning to it’s not about the the rain cloud it’s learning how to dance in the rain
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I say all of those things there’s a snoopy cartoon they’ve done
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yeah yeah actually during cancer treatments that cartoon yeah really resonated with me
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you know how I write lots of songs I wrote a song dance in the rain yeah because of that
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because and it that really has a big effect on me don’t wait for the storm to pass just
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dancing the rain when the rain is hammering down around do you want to go to ground outside
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don’t wait don’t wait yeah yeah absolutely and I think you know it’s it’s trying to find the
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hope and the the joy in in times where it’s it doesn’t look particularly joyful
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there are there’s there’s different and different people will do different things as a result of
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that but it’s about trying to be go back to who you are what you enjoy doing what kind of
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glimmers of positivity can be within what’s quite a difficult time for you and I suppose
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that’s something that the the carer and the patients can do together as well as a way of
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giving them a chance to talk I mean that’s that seems to be a really logical way of doing
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because you go to the potager as well I do yeah the potager is a garden that’s near constantine
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and they’ve very generously opened up their greenhouse to to the cove and they invite cancer
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patients and their carers and their carers there yes so you’ve taken your mum I’ve taken
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my mum and dad yeah so we’ve we’ve met a lot of people up there absolutely there’s so many really
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nice things that are being done and kind of um sort of health delivered in different settings
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so you know the kind of gardening thing’s absolutely brilliant for that perspective
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there’s a whole host of different gardening initiatives around Cornwall Bounder Therapy
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Gardener Eden’s the other one yeah absolutely and we’ve got we’ve got ones that are locally
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within St Agnes and we’ve got there are a whole host of them in different places as well so
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it’s um yeah that’s that’s where the real neighborhood thing comes in you know that’s
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where you’re kind of delivering care outside of the traditional doctor’s office and that
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that is really important for people’s well-being that’s the exciting and what part does the
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GP or the surgery the practice play in actually developing some of these initiatives
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is there a part or um is it just about uh you know signposting to them it’s it can be a mixture
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depending on the practice and depending what kind of things they’ve got available to them
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there’s a lot of links to those kind of community groups and depends on the kind
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of area even and what kind of things that are available I’m thinking Newquay Orchard
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Newquay Orchard is a very good one for for that so there’ll be links there from I’m sure
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Newquay practices to to the orchard um there’s some exciting things in development in different
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places as well about using open space so can we mention any of those not at the moment
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but into green space is very important uh and you know and the the side of things around um
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also what they call the blue therapy as well sort of sea therapy as well you know in terms
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cold water yeah so on thursday I’m starting cold water swimming yeah cove to coast organized
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by the cove so again Macmillan um involved in that so thank you to them yeah so there’s
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so many great things and the benefit of Cornwall is that we’ve got such a lot
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of open space to be able to enjoy that and that’s kind of getting back to what you
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would like to do um and how you would like your life to be and that is so important a
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lot of that uh is offered through organizations such as Macmillan what part does the GP play in
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referring to some of these uh these other services that’s where the social prescribers
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come in really great because they’ve got all the connections to all of those different
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things what they don’t know about the local community and the opportunities available isn’t
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so if you can um depending on your practice you might be able to kind of say
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to the receptionist I’d like to speak to the social prescriber directly or you might need to
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be referred from your GP to them um but they are invaluable in being able to connect and link
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people up to those things and they will tailor it to yourself as well rather than this is
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what’s available okay what do you like doing oh you like art okay we could do this one or
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you’d like to go and have lunch with some ladies that would go to that one you know or
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like to do some walking or so there’s lots of different things some donkey therapy yeah well
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whatever plays your boat my thing so what’s been your favorite therapeutic
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event that’s happened during your cancer journey uh I think for me is the music therapy which
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is tonight it is tonight yep yep there’s a new a new round of music therapy starting
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they’re really integrating it to the cove into um actually what they deliver for patients they
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are and I believe that that’s for patients and carers as well or it it was I think it probably
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still is well I’m not totally sure how it works now but um they are developing that service
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and so there’s art as you say there’s walking the coast path there’s music
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craft group there’s tai chi there’s walking there’s I call it chai tea chai tea yeah you would
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wouldn’t you um I’m trying to think of all the different groups there there is
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and there’s also um like groups that meet up regularly just to chat to just just that’s what
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started happening with the cove not the cove the potager so you go on their course I
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eight sessions at the potager and once you finish their course they send you to a group
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which meets once a month which isn’t the course but you just meet other people who have done
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the course and you use the potager just for socializing socializing socializing because
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again going through cancer treatment can um you can lose your social life can’t you
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um and actually I’ve made a lot of new friends by socializing with other cancer um patients or
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people that have let’s say beaten cancer yeah because I think you know if you’ve gone through
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that cancer journey and you’ve got a shared point of view in some sort of way yeah I think
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you should celebrate the fact that you’ve you’ve beaten it share this podcast on your social
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media so others may benefit well we’re coming to the end of this week’s show and uh I’m just
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going to point out the fact that I’m not a doctor myself I’m not a counselor are you
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no I’m not qualified to be a doctor or anything medical are you a doctor I am a doctor
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yes
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and um I know what you are very good at doing I’m quite good at giving a hug here and there
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where where where here now let’s let’s do that over there let’s give everybody a big hug
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because because big hugs from us because when you give a hug you get a hug it’s getting
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cheesier every week and I’m not sure how much cheese I can cope with oh I like a bit cheese
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oh what’s your favorite cheese oh I just like cheddar is behind me yeah did your cheese uh
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taste change during treatment um no it didn’t I was lucky but I know that people do suffer
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with taste changes such as I I went off chocolate how dare me go off chocolate
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cheese did you did you stay with cheese um very strong cheese yes it had to have very strong
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cheese yeah anyway look I think that’s uh another one with the dietitian some
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anyway look thank you for being with us again I’m sure there’s always loads of things to
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chat about to do with uh how the GP and the cancer patients relate to each other and the
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services available thank you once more this week thank you very much Matthew and Emma
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always a pleasure and thank you Emma for putting up with me again I know I need a medal
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did you need counseling I need counseling I need some help
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see everyone next week see you again bye
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dance in the rain thanks to the national lottery community fund for supporting this podcast