Health & You: Chemotherapy and Swimming


Chemotherapy is a cancer treatment that uses chemicals to blast cells. It’s not a blast of radiation, but a chemical treatment that targets cancer cells.

Chemotherapeutic agents kill cells that quickly divide – such as cancer cells. How do infections and chemotherapy and swimming all relate?

  1. Chemotherapy
  2. Chemotherapy and Infection Risk
  3. Chemotherapy and Swimming


For over 50 years, chemotherapy or ‘chemical therapy’ has been a part of cancer treatment. Chemotherapy injections or pills can be used by itself or in addition to surgery or targeted radiation treatment. Surgery and radiation destroy the cancer cells in a given region, while chemotherapy works well throughout the body.

Cancer cells multiply at a quicker rate than normal cells; therefore chemotherapy is made to target multiplying cells. The more they divide, the stronger the effectiveness of the drug will be.

With chemotherapy comes the side effect of normal cells being destroyed as well. These cells can be found in the hair, mouth and intestines. Side effects of chemotherapy include exhaustion, mouth sores, nausea, hair loss and brittle nails.

Additionally, the immune system can become weakened which allows for more infections. Because of these risks and side effects that accompany chemotherapy, many patients can be devastated with the option of chemotherapy.

Cancer treatment in many cases requires the use and access of veins for different options for treatments – including chemotherapy, blood transfusions, antibiotics and intravenous fluids, or IV fluids. To make procedures and treatments such as these easier, doctors might recommend using a catheter or port, however these present another infection risk.

blue-crossCancer and Infection Risk

Infection occurs when germs are allowed to enter an moist opening on the body, multiplying and mutating. This is common with those who suffer from cancer, as the immune system is in a weakened state. Fortunately, there are many ways to prevent and treat possible infections.

Catheters are long plastic tubes that deliver treatments and drugs that can manage side effects and symptoms of cancer directly into a vein. Washing hands before you touch the catheter helps prevent infection. Germs from dirty hands can lead to germs getting into your system, which is worse when the immune system is weakened.

Other helpful tips include changing the bandages when necessary – as germs can build up on an old bandage. Prevent air from getting in the catheter by making sure the clamps are tight when the tube isn’t in use. Avoid breaks or cuts in the catheter, and keep the catheter from being underwater.

After a chemotherapy treatment is when one is most vulnerable to infectious disease. Viral infections like influenza or the common cold are easily transferred from person-to-person in crowded areas. Some ways to help prevent infection include washing hands often and avoid touching hands to mouth or eyes.

Mouth care is also important; keep the mouth clean by brushing teeth twice a day; use mouth rinses without alcohol, and do not use floss. Food safety is important as well – and it is even more vital during chemotherapy to remember tips you follow as usual such as washing hands before preparing and consuming food, cooking food well, keeping raw foods away from ready-to-eat food, wash vegetables and fruits, and keep cold food cold.

On a related note, those at highest risk for infection shouldn’t drink water that is not properly treated. Boiling water for a full minute kills cryptosporidium and other waterborne organisms.

Pay attention to white blood cell counts during cancer treatment. Your health care professional should let you know when you receive a treatment that will lower your white blood cell count, and you should ask when white blood counts are going to be at their low point, when your body will be less likely to fight off infection.

blue-crossChemotherapy and Swimming

The American Cancer Society’s message regarding exercise is clear – moderate exercise during treatment is beneficial. Chemotherapy’s side effects can reduce the motivation to exercise for some patients, though it is important to keep as active as possible. Why? Exercise can actually increase effectiveness of cancer treatment, boosting odds of survival. There are other advantages to exercise – a 1999 study showed that there was a significant decrease in fatigue among chemotherapy patients, and that there was an indication of less fear, anxiety and other psychological distress overall.

Swimming can cause accidental ingestion of water and can therefore increase the chances of obtaining cryptosporidium or other waterborne pathogens. It is important to make sure to avoid situations where you find yourself inhaling environmental spores found in and around moist, dark areas such as rotting leaves and compost piles. Public hot tubs and spas are not recommended because there are some bacteria that can survive in the warmer water. However, if the hot tub is disinfected properly, there is little to no risk.

Swimming pools and hot tubs are not the only risk – swimming in lakes, rivers and oceans can bring on recreational water illnesses. These can be spread from swallowing, inhaling and contacting contaminated waters with open eyes, or open cuts or sores. The most common recreational water illness is diarrhea. Other illnesses from contaminated water include gastrointestinal, skin and mild respiratory infections.

Pools and hot tubs that are disinfected properly can be a safer swimming experience, especially low-use residential pools – but pH and disinfectant levels should be checked on a frequent basis for disease-causing germ control, and the water should be over-filtered, with long daily filter runs.

In many cases, chemotherapy patients are fitted with a port-o-cath for injections. Cover a catheter or central line with a suitable water barrier like a Tegaderm and tape over the area fully before swimming, and change bandages after each swim.

The take-home from this is to be sure to bring up these points with your doctor. Ask about your specific case, and if swimming and/or hot tubs should definitely avoided altogether. All cancer cases and infection susceptibility vary so it is important to communicate at various stages with your doctor about when swimming during chemotherapy is beneficial or best avoided – for you.

Get your Swim On, America

Dr. Pool


“Catheters and Ports in Cancer Treatment.” Cancer.Net. N.p., n.d. Web.

Patural, Amy. “Chemotherapy 101 – Cancer Treatment.” N.p., 16 Feb. 2010. Web.

“Infection.” – Managing Side Effects. N.p., n.d. Web.

Facey, Dorian. “Exercise During Chemotherapy.” LIVESTRONG.COM, 21 Oct. 2013. Web.

Millehan, Jan. “Swimming & Chemotherapy.” LIVESTRONG.COM, 19 Feb. 2014.Web.

Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Billing and RCM, Medical Transcription, Pre-Certs with AzaleaHealth EHR.   We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information.  We have education programs in Medical Scribe Specialists. #medicaltranscription #azaleahealthEHR #revenuecyclemanagement

5 Best Practices To Ensure A Smooth, Expedient ICD-10 Transition

The ICD-10 Compliance date is looming and it is imperative that healthcare providers be prepared to make the transition. It affects everything from claims processing, physicians’ workflow, and patients’ access to care. Many organizations may be rallying employees and resources in order to make the switch from the ICD-9 to the ICD-10 coding for medical diagnoses and inpatient hospital procedures before the implementation date of October 1, 2015.

To make matters worse, the transition is not easy, but a major undertaking with nearly 19 times as many procedure codes and almost five times as many diagnosis codes in the ICD-10 than in the ICD-9. While the ICD-10 switch is definitely necessary, as the outdated and clinically inaccurate ICD-9 has not been updated since its installation, in 1979, the ICD-10 stands to enhance the quality of healthcare, improve data for epidemiological research, as well as enable physicians to make better clinical decisions. However, this is dependent on the ability for the healthcare industry to make a smooth and accurate transition to the new International Classification of Diseases, according to Richard Milam, president and CEO of EnableSoft

In order for healthcare providers to successfully meet the ICD-10 deadline, Milam suggest five best practices to ensure an expedient, smooth ICD-10 transition:

Richard Milam, president and CEO of EnableSoft
1. Employ Robotic Process Automation That Does the Work for You

“You” is meant to imply the entire organization because that is how many resources it will take to have the ICD-10 switch completed by the deadline if Robotic Process Automation is not used to update and add the multiple new codes into EMR, NDC, medical billing, and claims processing data systems. Certain softwares may have to upgraded or replaced to support the 68,000 diagnoses codes and nearly 87,000 procedure codes; however, through a series of human-directed scripts, Robotic Process Automation technologies will populate the specific fields in the data systems with the ICD-10 data required. The already costly transition to the new ICD-10 can be mitigated by not having to outsource or hire new employees to enter the new codes manually. Furthermore, the data transition can take place over the course of a few days, not a few months, ensuring healthcare providers will be ready to transition to using the new ICD-10 codes.

2. Test Your Software

Not only should you confirm with your clearinghouses, billing service, and payers that they will be upgraded and compliant with the ICD-10, but when they will be ready for testing to occur. Robust end-to-end testing must occur with your software in order to ensure claims are being accepted properly and processed by insurance contractors, Medicaid, Medicare, and other payment processes are operational. Test internally to ensure transactions can be generated and sent with the ICD-10 codes and test externally to ensure the transactions are successfully received by payment providers and that the payment can be processed correctly. After October 1, any ICD-9 codes used in transactions will not be accepted for services and will be rejected for payment. Failure to test your software properly can result in disruptions in patients’ receiving the treatment they need and receipt of due payments.

3. Educate or It All Falls Down

The updated, enhanced medical coding that is to enhance and improve patient diagnoses, performed procedures, treatment, and billing will not prove capable of these abilities without humans to employ its codes, terminology, and procedures appropriately and correctly. You must educate your staff about the changes to the ICD-10 and perform practices and routines in order to prepare for the change. Have each of your staff participate in educational seminars in order to become informed of the changes and how that will affect their position, the procedures patients are to undergo based on the new diagnosis codes, as well as the improved treatments that patients are to have performed. Assist and inform staff by identifying the 50-100 most commonly used ICD-9-CM diagnosis codes based on specialties and determine the equivalent ICD-10-CM codes, and have this information accessible before and after the implementation of the ICD-10. Having your staff prepared and knowledgeable about the ICD-10 will reduce delays in patient care and procedures, which is the reason for the ICD-10—to deliver improved diagnosis and advanced medical treatments that will enhance patients’ quality of care.

4. Implement an Effective Communication Method and Coordinate Conflict Resolution

While making the data transition and update to the new and diverse medical coding that is in the ICD-10, it is imminent that there may be delays in processes, confusion over coding and form completion, as well as workflow changes. Make sure your employees know who they can contact or call on if they are unsure of what code to report, how to complete a form, or other transitory questions that may arise following the implementation of the ICD-10. Identify leads and supervisors for each workflow and specialty area that will be available for their staff requests and questions, and make sure those individuals are highly educated on the ICD-10 and have the authority to execute a resolution. Additionally, determine how transactions handled just prior to the compliance date will be handled in order to ensure payment processing will occur—and more importantly—patients are covered financially and receive the best treatment. Identify critical areas or procedures that may be challenging to transition to using the ICD-10 and have practical resolutions for those practices ready to be executed if, and when, needed.

5. Obtain the correct medical documentation and update your forms to support the ICD-10.

Patient intake forms, EMR forms, insurance forms, and superbills must be updated to support the ICD-10 codes. In order to have patient medical records completed correctly and treatments performed effectively, in addition to have payments process, healthcare providers, clearinghouses, and payers must update their forms to reflect the codes in the ICD-10. Physician forms must be updated with the new medical terminology and diagnoses and procedural codes, along with superbills. Identify categories of uncommon services and diagnoses and determine units, time, and cost for each category in order for physicians to be able to report in the EMR and on superbills. Determine and have readily available a list of common or most frequently used abbreviations to ensure they are utilized correctly and correspondently with the ICD-10 terminology and codes. Lastly, and this goes without saying, obtain the updated and correct documentation that will stand as educational and reference material in regards to the ICD-10. The American Medical Association publishes the ICD-10 codebook and other supplementary documentation on topics such as anatomy and physiology, mappings, and coding workbooks. Make sure to have these ICD-10 Bibles available, and in all areas, for staff and physicians to reference when needed or desired.

The healthcare industry is about to embark on an intense change in treatment, reporting, and payment processes as the ICD-10 Compliance date approaches. While the ICD-10 is definitely necessary to reflect advances in medicine and detailed diagnoses, the change is extremely disruptive for healthcare providers. By employing efficient technologies and engaging effective strategies, healthcare providers can execute the ICD-10 transition quickly and accurately by the compliance date.  READ MORE

Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Billing and RCM, Medical Transcription, Pre-Certs with AzaleaHealth EHR.   We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information.  We have education programs in Medical Scribe Specialists. #medicaltranscription #azaleahealthEHR #revenuecyclemanagement