Chemotherapy and nausea: they go together like a horse and carriage. You may not be able to escape nausea, but there are things you can do that should alleviate it to a certain extent.
I’m told that the drugs are not nearly as hard on the body as the drugs that were used for chemotherapy years ago. Also, after being treated with two different kinds of chemotherapy, I can say with confidence that not all chemo regimens necessarily cause nausea. Moreover, the anti-nausea drugs on the market are pretty effective. I’m sure what I experienced was much, much better than what chemotherapy patients went through a couple of decades ago. Still, it was no fun. My first chemotherapy cocktail packed quite a punch.
The impact was not immediate. Generally, a few days to a week after a chemotherapy infusion was when the nausea was worst. I could describe my worst nausea experience in detail, but I don’t think you want to know and I don’t feel like reliving it.
The strategies that worked for me were medication, acupuncture, diet, and rest, pretty much in that order.
- Medication: Your doctors or nurses may have you prepare for chemotherapy by taking steroid medications for a couple of days. They may give you a dose of Zofran (ondansetron), an anti-nausea drug, just as you are beginning the infusion. Then, you should also have a standing supply of Zofran and Compazine (prochlorperazine) at home — be sure to get those prescriptions filled before your first chemotherapy treatment. What worked best for me was checking how often I could take Zofran and Compazine, and then taking both, around the clock, whether I felt nauseous or not. I took them on a staggered schedule, so that if the Zofran was starting to wear off, I still had a few good hours of Compazine in my system, and vice versa. When I didn’t do this, I regretted it. Chemo nurses confirmed that the best way to treat nausea is to try and stay ahead of it as much as possible, using Zofran and Compazine for prevention instead of relief.Some other prescription medications may help with nausea as well, such as certain anti-anxiety and migraine medications. These can be useful for particularly bad days when, say, you have anxiety AND nausea, or nausea AND a migraine – and you may be able to keep taking the Zofran and the Compazine at the same time. (Make sure your oncologist has an up-to-date list of every prescription and over-the-counter medicine you might take, and always double check with him or her about possible drug interactions.) When these medications and other strategies didn’t relieve my nausea, the chemo nurses suggested a drug called Emend (aprepipant), which I could take for three days beginning with the infusion day. It seemed to help. I found it comical that I was taking as many drugs for nausea as for cancer.
- Acupuncture: My experience with acupuncture deserves a whole post of its own, which I will eventually write. Here, though, let me just say that I think it helped.
- Diet: The nutritionist at the cancer center recommended small, frequent meals. She recommended trying to get as much protein as possible to go down and stay down; one trick that often worked for me was cutting up cooked chicken into tiny pieces, and mixing them into plain rice. A friend with culinary training recommended ginger, which turned out to be great advice for me: some ginger ale, ginger tea, or chewing on a little piece of candied ginger often helped settle my stomach. Cold foods were good, because the aromas weren’t as strong and so didn’t trigger my nausea quite as much; I became a fan of the ham sandwich. And sometimes just a small bowl of plain rice or a plain baked potato was all the dinner I wanted. I managed to keep team-teaching a college course during chemotherapy, which is another story, but the nights I was teaching I sucked on peppermints or other hard candies, which somehow kept my stomach a little calmer. I lived in fear of having to vomit while teaching, but managed to escape that.
- Rest: Sometimes what worked was just crawling into bed, and hanging out there with no stimuli – no reading, no sounds, no smells, no motion. Think about feeling seasick, and then try to do the complete opposite of being on a moving boat. I think it was important for me to give in to the fatigue, and sleep all day when I felt like sleeping all day. The more tired and stressed I was, the more nauseous I would feel when I was out and around.
Unfortunately, on that triple-threat chemo cocktail, my stomach never really felt normal. Even with all the medications, acupuncture, diet strategies, and rest, there was a constant feeling of queasiness. I never liked to sit very long at a table where people were eating; after 20 or 30 minutes, I wanted to get away from the sight and smell of food. My strategies didn’t keep me from feeling nauseous, but they helped me manage it.