Weathering the Storm
By Nancy Gay
Spaghetti models, eyewall and projected path are all too familiar terms for those living in Hurricane Alley. The sight of a swirling cyclone unleashes a sense of shakiness even to those most prepared to weather the storm. By the time a storm is named, residents within the cone of uncertainty have already boarded up, filled up their gas tanks and have a pantry full of non-perishable food and bottled water, but if you’re a cancer patient, a hurricane is another blow to an already unpredictable future.
Cancer often creates feelings of powerlessness, fear and uncertainty, but when there is trouble in the tropics; patients may panic as hurricane preparations change the trajectory of their treatment plan. Unlike storing water, food, batteries and flashlights, patients can’t stockpile chemotherapy and radiation at home.
It’s important to have a hurricane plan in place long before there is red on the radar. Hurricane season runs June 1 – Nov. 30, with the most active season for storms being mid-August through mid-October.
Moffitt Cancer Center’s level of care will not change during a storm. If a hurricane threatens Tampa Bay, patients can stay up to date on possible cancer center closings by logging onto the Patient Portal or calling the Patient Hotline at 813-745-3500. If Moffitt has to cancel your appointment due to a hurricane, a representative will contact you.
Before a storm, it’s crucial to write down information about your treatment in case you have to evacuate. Key items include:
- Type of cancer and stage of cancer
- Type of treatment like chemotherapy, radiation, or surgery
- Date of your last treatment and the cycle you are on
- Name of your doctor and treatment center
- Any medicine you’re taking (cancer medicines and other medicines, including over-the-counter drugs). If you don’t know names, describe it by color; size; shape; shot, pill; how often you take it; or bring the pills with you in a bag
- Other illnesses or health problems
The American Society of Clinical Oncology (ASCO) and the National Cancer Institute (NCI) developed a wallet card for cancer patients in case of a natural disaster. The card is free and can be downloaded here. Patients can also call 1-800-4-CANCER (1-800-422-6237) to request a card. ASCO and the NCI recommend writing your information on the card and then laminating it to protect it from possible water damage. It’s also important to have your insurance card with you at all times.
Information about your physicians and treatment is available on the Moffitt Patient Portal, but it’s good to have a hard copy of the information just in case your cell phone or laptop battery dies and/or the internet and cell phone signals are down.
Moffitt is not a shelter during a storm. Moffitt advises patients who believe they will evacuate to a shelter during a hurricane to register for special needs disaster assistance with your county. The Sunshine Line is available for free transportation to a special needs shelter for those in need of transportation assistance.
A special needs shelter is able to care for people whose medical condition may require the use of electrical equipment, oxygen and/or dialysis. Shelter staff also has the ability to treat individuals with physical, cognitive or medical conditions who may require assistance from medical professionals. Keep in mind that while special needs shelters provide more care than a general shelter, they do not provide the level of care at a medical facility.
If you do evacuate to a special needs shelter, the American Cancer Society recommends meeting with the healthcare professionals on site immediately. It’s important to let the staff know you are a cancer patient currently receiving treatment. If you’ve just gotten chemo and have very low white blood cell counts, your risk for infections may be higher in a crowded public shelter. You may want to wear a mask while at the shelter to minimize exposure to germs.
Many shelters have nursing staff that can help get you to an emergency room. Seek emergency medical treatment immediately if you experience:
- A fever of 101º F or higher taken by mouth, or a temperature of 100.4º F if it lasts more than an hour
- Shaking chills or sweats (often goes along with fever)
- Redness, swelling, drainage, tenderness, or warmth at the site of an injury, surgical wound, or central venous catheter, or anywhere on the skin including the genital and rectal areas
- A new pain or one that’s getting worse
- Sinus pain or headache
- A stiff neck
- A sore throat
- Shortness of breath or cough
- Burning or pain when you pass urine or bloody or cloudy urine
According to the American Cancer Society, if you’re in an area where safe water and food may be a problem or injury is a risk due to the natural disaster, you may be asked to get shots for hepatitis A, hepatitis B, the flu, pneumococcus and tetanus. While these vaccines are safe and may be necessary, make sure the person giving the shots knows you have cancer and when you last had treatment. If you can, talk to your doctor or a local doctor before you get any shots.
It’s very important that you do not let anyone give you a “live” vaccine unless a cancer doctor, who knows your medical history, says it’s ok. Vaccines like the flu nasal spray, varicella zoster (for chickenpox or shingles), measles-mumps-rubella (MMR) and smallpox have live virus in them. (Please note, the flu shot is ok, only the nasal spray has live virus in it.) Sometimes the live viruses can cause serious problems for people with weak immune systems. Also, try to avoid close contact with people who have gotten live virus vaccines.
Though the storm will disrupt your schedule, it’s important to keep taking your medications on time. If you don’t have your medicines or know where they are, try to get in touch with your doctor, clinic or health insurance company.
ASCO recommends creating a waterproof supply kit before a storm. It should include items like your medications, wound care dressings, antiseptic spray, and other items you need for routine care. Put the contents in a re-sealable, waterproof plastic bag to keep them dry. If you have any liquids in your collection, such as rubbing alcohol or liquid medications, use a separate bag for those.
When creating a first aid kit in advance of a storm, be sure to keep low platelet and white blood cell counts in mind. You’ll want to stock the kit with dressings and antiseptics for cleaning wounds and medications for nausea, diarrhea, constipation, and fever.
Additionally, it’s important to:
- Protect yourself from germs by washing your hands with soap and water as often as possible. Scrub your hands for as long as it takes you to sing “Happy Birthday” from beginning to end twice. If you don’t have access to soap and water, ask for alcohol hand sanitizers (that are at least 60% alcohol) and follow the directions on the product.
- If there isn’t clean water or you don’t know if the water is safe, drink only bottled water or boil water for one full minute. Allow it to cool before drinking.
- Make sure meats are cooked thoroughly and fruits and vegetables are washed in clean water. Don’t eat cooked foods that have been left out at room temperature for more than 2 hours. Be sure to ask your doctor if there are foods you should avoid until you can get into permanent housing.
- Keep any cuts or wounds covered with bandages unless your doctor has told you otherwise. Use antibiotic cream every day, if you have it.
- Don’t share toothbrushes or eating utensils or cups with anyone else.
- Don’t get vaccinations unless a doctor who knows your cancer history says it’s ok.
- Bring clean bedding and towels to a shelter if you evacuate. Do not reuse anyone else’s towels or sheets.
- Bathe or shower as often as you can and use clean towels to dry.
The American Cancer Society says if you are still in the area where your cancer doctor or treatment facility is located, but have stopped treatment due to power outage, loss of transportation, damage to your home, or damage to the doctor’s office or treatment center, contact your doctor as soon as you can and find out what you need to do to continue treatment. If you can’t get in touch with your cancer doctor, try your treatment center, local emergency room, or your regular family doctor.
If you had to leave the area where you were getting treatment, you need to find a new cancer doctor and treatment center as soon as you can. Ask for help from the shelter staff, Red Cross, Salvation Army, or local health department. If all else fails, go to a local hospital information desk and ask for help.
If a hurricane causes Moffitt to close, the facility will reopen as soon as it is safe. A Moffitt representative will contact patients who need to reschedule their appointments. If a storm is threatening Tampa Bay, patients are advised to check their patient portal and the Patient Hotline (813-745-3500) regularly for updates. Patients are advised to have a hurricane plan in place by the start of hurricane season on June 1.