What would you do?

[Terri B]

You guys have been great in giving advise and tips to all us newbies. I have one for you to analyze (did i spell that right?).....

Picture if you had NEVER had chemo before, so you don't know how your body is going to react.

You are going to be taking your first chemo treatments on a WEEKLY cycle so the doses should be smaller and more tolerable. You have a strong stomach, and don't get sick very often. You did not have morning sickness with any of your pregnancies....

You are hearing all the advise to take your anti-nausea meds BEFORE your treatment to "stay ahead" of possible nausea. Knowing the anti-nausea meds will knock you out cold, Here's the $10,000 question:

Would you chance it the first time & see how your body handles it? Or would you take the anti-nausea meds anyway?

[Sheila]

Terri
A personal choice, but I would err on the side of caution...hard to get it under control once it starts....you are always playing catch-up...kind of like with pain after surgery etc...if you wait too long to take the meds, its takes alot longer to get relief.....

[Ruth]

Terri ~

Sweetie, this is an easy one for me. Take the meds. Of course this is only my opinion and folks may disagree but I did have weekly taxol/herceptin for 12 weeks. Also, take the pain pills BEFORE you start aching. I found this out the hard way and tried to catch up. It took me until week #6 before I premedicated myself with the pain pills. I always took the antinausea because that was not a catch up that I wanted to try. I had extreme nausea with pregnancies (but this was caused from hormones...which is different). I never had a bad stomach with the flu, car rides, boats and everything else.

Hugs ~ Ruth

[Terri B]

Thanks so much for the replies....

I'm so glad to be able to come here and post a question like this and not get people rolling their eyes at me! ;)

Did you ladies work through your chemo? I guess this is what i'm trying to get to. will i be able to work if i'm drugged up?

[Ruth]

Terri,

We will NEVER roll our eyes...we all asked the same questions one time or another!

What is your job? Are you on your feet a lot? And what day of the week is your treatment? I definitely worked with Taxol/Herceptin but couldn't function well on A/C. I think it can be done depending on what your job is and how you respond to the taxol. If you have to be on your feet a lot or carry things (especially delicate breakable things) it may be harder. I broke lots of dishes before we went to paper plates! LOL

You won't be too drugged up. The nausea meds are usually there for the first 24/48 hours I think? Am I right anyone? I don't remember taking any nausea pills after I received the taxol. The benedryl made me sleepy and then I took pain meds that made me mellow but not sleepy.

[StephN]

Hi Terri -
Which chemos will you be getting? Many of us were on a weekly or dose dense schedule.

In my case I had Adriamycin for 12 weekly before Taxotere on a 3 week schedule. The nurse will give you a premed dose of an antinausea drug before starting the chemo. It was in the IV for me. I took a small dose of decadron steriod by mouth and after about 15 min the chemo was administered.

For some reason I NEVER had nausea. Just one little wave about 6 am the morning after my first dose, which went away in a matter of minutes. I had the pills to take, but what they gave as a premed was enough for me.

So I would go with their program at infusion and then see how it goes at home. You may be just fine. I did have some loss of appetite at times and the mouth sores were the worst side effect for me.

Hope it goes well for you! I thought of an anteater going through my veins and gobbling up those cancer cells...

[PinkGirl]

Hi Terri B
I would definitely take the anti-nausea meds. I am
also someone who does not usually get nausea or vomit
but I wouldn't chance it with chemo. I did not vomit but
I had some nausea even with the meds.

The anti-nausea meds did not knock me out, they gave me
major, super-duper constipation. This is also something that
you shouldn't wait for.

As for working, everyone is different. Some continue to
work and some are either in bed or on the couch. You'll
have to wait and see how the drugs affect you.

You have such a great attitude, I know you're going to
be fine and deal with whatever pops up. Good luck with
all of it and keep the questions coming.

[lexigirl]

Hi Terri,

I just wanted to concur with the other wise ladies here.
Take the anti-nausea meds. I was feeling really good after my third day out from tx and didn't take them.
I paid the price for the whole day. Very upset tummy to the point of tears. (I am a big baby when I feel nauseaus). I also had the constipation from the meds. Try to keep ahead of that and although not fun, the tx really is doable.

Big Hugs,
Lexi

[Terri B]

Ladies,

I will be on 12 weekly doses of Taxol/herceptin. First one on a Monday.

My job is pretty much sitting in front of a computer all day, so no exertion there BUT... I do get sleepy sometimes ;P

I would just hate to take something that would knock me out for 48 hrs (2 work days) and then have to repeat the very next week. 'specially if I find out later that I didn't really need them! Oh well, such is a dilemma, right?

You guys are sooooo helpful, though. Just to be able to talk to someone that has been through it is priceless!!!

[Pam P]

I've been working through many different chemo meds. Currently I'm on weekly taxol/avastin. I'm only getting the pre-med antinausea now, seems to be enough for me with this combo. With other chemos I took more anti nausea drugs. Some made me sleepy (ativan, compazine) but zofrin and anzamet didn't make me sleepy.

[StephN]

About the dosing schedule.
Many gals who want to keep working take Friday off and do their clinic day then. That way they have the weekend to get over the most immediate of the side effects, and can have the first part of the week to work when their blood counts have had a chance to recover and they are not so tired.

What I am speaking of here is aside from any nausea issues which may crop up. The fatigue is the biggie for many of us and your body needs a couple of days to do its work and process the chemo.

Ask your onc nurse or doc about making a switch.

[Terri B]

Well, Stephn, here's the dealio on that:

My Onc demands to see me once a week. Period. She is in this particular office only on Mondays. The rest of the week, she is a lot farther to travel to. So i have to kill two birds with one stone. Either way, I will have to make an office visit on Monday.

[hutchibk]

Hi Terri - such a wise woman to ask the question ahead of time...

I never had full-blown nausea. I did get queasiness (sp?), for about 3 days on about day 3 after a treatment. I am positive the anti-nausea meds were tremendously helpful in keeping it limited to only queasy. And the take home anti-nauseas definitely helped with the queasies!!

[Terri B]

Well, my "take home" anti nausea happens to be phenergan. I KNOW that puts me to sleep!!

Glad you consider me a "wise woman" haha! Many might think i'm a "bugaboo"!! :D

[Gerri]

Ditto to what everyone else has said here - take your meds before you need them. I had a different regimen (AC followed by Taxol & Herceptin) and never got sick - queasy yes, but that was easily solved by Sprite and saltine crackers. I felt better if I had a little something in my stomach. I had my chemo on Fridays and then back to work on Monday. My anti-nausea meds were Zofran and decadron for the first three days post chemo, then nothing. Since you already know the effects of phenergan maybe your onc will give you something else. I worked full time during treatment, for myself more than anything. Taxol gave me neuropathy big time, but since I also have a desk job I was able to handle it okay - most days. The most important thing to do is listen to your body. If you need to stay home do so.

PinkGirl was right on about the constipation! YIKES! I learned to take a stool softner starting the night before chemo - it helped a lot.

Good luck Terri! You are going to do just fine.

[Terri B]

:-SS

Good grief, I need a chill pill. No, hell, I need a beer. I'll be okay, I know by now that the anticipation is the worst part.

Thanks to all the angels here.

[Faith in Him]

Terri,

The first chemo is always a huge hurdle to overcome. But once it is over, you will feel better about it. I agree with the others, take the meds. I will be thinking about you.

Take care,
Tonya

[Sheila]

Terri
OK so now I am back with more advice....I was on Taxol and Herceptin every week, then every 2 weeks for 10 months....they gave me compazine to take if I needed it....never had nausea with any treatments...I took it day 1 only, never again...I was on Avastin too for 6 of the months. Again, everyone's tolerence is different...I did however get zoned out from the Decadron IV, Benedryl IV and they gave me pepcid which acts as a histamine blocker...to prevent allergic reactions...make sure someone goes with you...if you get the heavy duty premeds, which most on Taxol get, you are NOT gonna feel like driving...you will want to be napping...it makes me sooooo tired...but these meds are a must as many people have very nasty allergic reactions to Taxol, and these prevent it.....I usually feel like "dog poop" for that day....just tired, not sick, then the Dec kicks in and you have energy like never before!!!!!

[ElaineM]

Hi,
I would do what the doc and the chemo nurses suggest until I find out how I am going to respond. Can you get your chemo on the last day of work for the week, so you can rest on your days off until you see how you respond?

[dhealey]

I had my taxol/herceptin treatments everyother wk. They gave me decodron and benadryl drip before starting the actual chemo. I would sleep through the whole treatment and then go home and sleep until the next day. I felt well enough to work the day after treatment. I never had to use the anti nausea meds with the taxol/ herceptin. I took 4 treatments of adramycin/cytoxin first, I did have to take anti nausea meds with these. I learned real quick to take them before hand. Thought I would be brave the first treatment and did not take them. I was as sick as a dog. Learned my lesson to do as I was told. Best of luck to you.

[Becky]

Like Sheila, I never had nausea issues with Taxol or Herceptin. I had some muscle and leg/neuropathy issues but not nausea. However with AC, I was very ill. I took a Zofran before even walking in the door and then took one every 4-6 hrs as directed for the first 3 days. AC is much different than Taxol. Also, if fatigue hits you on Taxol, it will be day 3 (with infusion day being day 1). The decadron drip keeps you alive and kickin' quite well with energy to spare (after the benadryl wears off). Then you crash - so, plan on the mid week break (possibly) as everyone is different. Also, I had the every other week "dense dose" schedule. Also, at that time, Herceptin was given yet and I got mine after the fact so I had Taxol and Herceptin separately so I don't know how much of a difference that makes.

Big hug to you for next Monday (Monday was my day too. I worked but it was rough during the AC. I did it Monday because then my weekends were grand to be with my kids and family. Sometimes work is well... not so grand anyway so I didn't want to give them my very best days).

[Bill]

Hey SweetPeaTerriB, you are wise to ask ahead of time. Nicola had Benadryl, aloxi and decadron as IV premeds. She was a trailblazer for Lapatinib(Tykerb)/Taxol studies with Herceptin at the same time. With the Tykerb, constipation was not an issue. Can't help with the work issue. Nikki was in a fair amount of pain from the outset (Stage 0 to stage IV liver mets outta nowhere), so they prescribed TR pain meds. and breakthrough meds. For about a year and a half or two, she never had nausea. The IV premeds did the trick, but then again, she couldn't work because of the pain meds and neuropathy from the Taxol. Just try to listen to the wise counsel of your sisters here and your docs/nurses. Take a "survey", like you are doing, and let the info. jell for a few days while you reflect on it, and the answer that is right for you will come to you. Like said, everyone is different. You're in our thoughts and prayers, Bill

[KellyA]

Hi there,

I would take the anti-nausea meds. I did, right from the get go, because I was told that it is very hard to catch up and recover once you get sick. I would always start taking them right away- the minute I walked in from chemo. I took two- one during the day, and one at night that caused a little drowsiness. I am a total lightweight with meds, and never ever felt drugged up. As a matter of fact, I continued to work as a preschool teacher and never missed a day of work during all of my chemo. I also have three boys at home. I did feel very tired by suppertime, but over all, I felt pretty good- nothing like what I expected. TAKE THE MEDS!!! They are wonderful!

Love, Kelly

[Mary Jo]

Hi Terri,
I can't really offer you any more advice as it's all pretty much been said BUT I did want to encourage you. You have a great attitude and are preparing yourself well. I am confident you will do well.

For what it's worth....I took my anti nausea medicine as they recommended and never had nausea issues. I will admit, my greatest chemo fears were "throwing up" fears. However, it never happened BUT I did take the meds faithfully.

I ask God to keep you safe as you go through chemo. May your body be protected from it's effects but work it's magic as it is intended to do.

Love to you...

Mary Jo

[sassy]

Terri,

I had the premeds, but only had to take Zofran once or twice following treatments. Never really got sick, just a little queasy a time or two.

As for work, I was able to schedule treatments on Friday, so I could rest up and be back to work on Monday. Worked throughout A/C, Taxol/Herceptin, Rads. Tired, but no major problems

Sassy

[chrisy]

Looks like you 've got a consensus on the "take the meds" question! I did, and never had a moment of nausea. Becky's right, the Benadryl will put you down (way faster than a beer), but my problem was that the Decadron would keep me up all night unless I took an Ativan. The Ativan was prescribed for nausea OR a sleep aid.

I was able to do my treatment on Fridays, then chill on Saturday. I was actually pretty much fully functional (at least I thought I was) except for the day of the infusion. I took some time off in the beginning under my doctors orders, but after a couple of weeks I was going absolutely NUTS so I made him let me go back to work.

You will have to decide all these questions based on how you feel. You may do very well, and have little side effects. I had weekly Taxol/Carboplatin/Herceptin and that was the case for me. I was a bit foggy but was determined not to let it stop me. I was also very lucky to have great support and understanding at work.

The first treatment is the hardest, because of the unknown. The right course of action for you will reveal itself! Remember, be gentle with yourself.

Good luck on Monday

[harrie]

Teri, I was on taxotere and carboplatin every 3 wks. I didn't have much of a problem with nausea at all. On the day of the tx I had benedryl and antinausea meds, but that was it. Nothing the day before tx and nothing after.
I did have this wierd hypersalivation problem each time and it lasted for days after tx. I don't know if that was my form of nausea or what. We could not figure out what was causing it and could not figure out how to alleviate the problem. Tried add'l antinausea meds as well as acid reflux OCT stuff, but it did nothing for my salivation. Was bothersome but temporary and manageable. Just spit a lot. LOL!
Maryanne

[atdec05]

Hi Terri,

I did 12 weekly TH for a recurrence. I didn't take anything the day before or after my treatment. I don't believe I took any anti-nausea meds. Are you being given anti-nausea meds for TH? Are you sure that's the only 2 drugs you're being given since nausea is not usually associated with TH.

On the day of my treatment I got pre-meds thru IV - benedryl & steroids (to prevent allergic reaction to Taxol) and zantac (I think) or some stomach meds because the steroid could cause stomach upset.

The Benedryl knocks you out so you sleep during much of your treatment. But I would be awake enough for the afternoon. The steroids could sometimes make me wired, so I couldn't go to sleep and the first time stayed up till 5am!

I wasn't working, but I think I could function OK the next day after treatment. My biggest side effect was terrible stomach cramps the first few times (side effect of steroids). Once I knew to take Pepto Bismol after the treatment I was OK.

I think you have to play it by ear, but TH was definitely more tolerable and I had more energy than when I did AC.

Take care,
Anna

[Terri B]

Wow, so much great advise!!

I will keep you guys posted on what I decide to do for this first round. My second round will include Epirubicin & Carboplatin 4 times every three weeks. I'm thinking that might be the tougher regimen.

Thank you, thank you, THANK YOU!!!

[kcherub]

Hey! The anti-nausea meds should not make you drowsy, unless you are having an Ativan IV with your treatments (they are anti-nausea, anti-anxiety). That won't last more than the afternoon...

I WOULD NOT suggest taking your luck the first time around and skipping the anti-nausea meds. I know everyone else pretty much said the same thing, but I am panicking a bit for you just thinking of you NOT taking them before! LOL

After my first treatment, on a Friday, I went back to work on Monday. I own my own business (children's boutique) and had a "babysitter". My store manager went with me. I felt HORRID. Not sick, just out of sorts. With me, it was the steroids, which I think pretty much everyone gets with a Taxane. The rest of my treatments, I took the following week off, but I also had the luxury of knowing it wouldn't endanger my job. Here is what I think--if you can, take the week after the first one and stay home just to gauge how you feel day by day.

I didn't really notice any "getting worse" with each treatment--other than the neuropathy, hair loss, and dread of the next one. The emotional dread of it was really actually worse than the physical actualities. Nonwithstanding the freaky steroids!

Take care!

[Terri B]

That Ativan sounds like some great stuff!

See, I don't know if i will be getting anti-nausea in my IV. I KNOW for a fact that phenergan will knock me out. That is what my onc gave me a script for.

I can't take the week after the first one, because i will be getting weekly treatments for the first 12 weeks!

I appreciate the advise!

[abitjaded]

Terri,

I second, tenth, fiftyith. Take the anti-nausea. A friend and I were diagnosed within months of each other. Same drugs. She had problems with drugs that did not get me, and vice-versa.

You have kids, so you know the rule, one pukes, everyone pukes. And so it goes. Nip it in the bud before the triple-plastic-bag-reinforced-trash-can-bedside needs to be deployed.

There are a great many different drugs that will work on the nausea (Ativan is like a sleeping pill to me). Ask for one that won't bug you with other side effects. They have them. Put the Dr. and nurses through their paces. They don't want you to feel lousy, either. Makes their job easier.

Avoid your favorite scents, at least for a while. I used to love a certain bath gel. Cannot stand it now because I associate the smell with, well, you can guess.

Also avoid your favorite foods unless you really crave them. Wait until you know what will and will not set off nausea. Kinda like avoiding the fresh meat aisle in the grocery when you are pregnant.

And hey, I bawled all the way through an MRI once, too.

Carla

[Terri B]

Touche' Carla!

Thanks for the kick in the pants!

[StephN]

Hi Terri -
What a great thread this has turned out to be!!

Just want you to know that EVERYONE should get a premed antinausea before the chemo starts running. I used to get Kytril and I did not have any side effects from that.

If I were you I would tear up that script for the phenargan and ask for something else. A newer one called EMEND has had some good reviews here. Just call up your onc's nurse and tell her that you want a different antibarf med. And ask what you will be given with your first treatment. I am sure the onc has written your orders and they are in your file.

This way you will have the scoop and not wonder about this over the weekend. Then just get the new med at any pharmacy (they can call it in) and take it if you start to feel queasy.

[Bill]

Hey Terri! Carla had some great advice, and like Steph said, I think everyone should be given IV premeds. Phenergan, in pill form can be given every 6 hours, I believe. Compazine, and Zofran, every 3-4 hours, I think. A fairly new med. Emend, has recently been approved as an IV premed. Also, in another thread somewhere, it has been discussed (study results) that fasting for 2 days before chemo. helps with nausea and chemo. effectiveness. just spoke with my Pharmacist who, in a nut-shell, said that "normal" cells go dormant during the fasting, but the cancer cells don't know how to behave, and are more likely to be hit by the chemo. Said the studies are very promising. This has been posted here on other threads, but sometimes with the technical stuff, my eyes glaze over and all I can think about is paddling and searing meat over an open fire. It was nice the way my Pharmacy source put it. Let us know how you're doing SweetPeaTerriB. Love, Bill

[TSund]

Hi, (from another Terri)

Ruth worked all through TCH chemo (accountant). She took all the drugs as directed the first time but quickly figured out that the "extra" nausea drugs (compazine, ativan, etc to be taken "as needed") outside of what they gave her in the chemo drip were unnessary for her. SHe took EMEND 3 days which seemed fantastic. The Decadron was the worst culprit for other side affects and she lowered the dose by 1/3 and then by 1/2 with no problem. She took the Benedryl in the chemo drip when she wanted the nap. :)

Also, I think Ruth did better because she was able to avoid the WBC boosters, so she didn't suffer their side effects. I think some oncs give it always, but I'm glad our onc waited to see how Ruth did on TCH. (we believe the astragalus and reishi mushroom extracts that we found out about on this site were a big plus)

Hope this helps and wishing you the very best.

[abitjaded]

Bill,

Really interesting about the fasting. My Radiation Oncologist told me to avoid anti-oxidants before and during the WBRT, then for a few weeks after. So I did not dose up on Vitamin C, obviously, but also avoided fruits and vegetables. This is supposedly because the radiation generates free radicals that hit the cancer, and you don't want the free-oxygen scavengering of anti-oxidants. Then the anti-oxidants could promote DNA repair in all cells, but especially to be avoided in the cancer cells.

He also told me to have a cup of coffee before the radiation, because there are some reports that caffeine helps the free rads stick around. Said he would not reccommend this to other patients for fear they would be up all night hugging the coffee pot.

Tried to do some Internet research about the caffeine thing, but mostly found rat studies that showed caffein was contraindicated. (Remember I'm the 30 year grunt Molecular Biologist, pretty good at MedLine.)

I wonder if the fasting causes ketosis at just a few days?

Carla

[theresaw]

I didn't take the med, and I like you never experienced morning sickness with either of my children. So saying that I didn't feel the queasiness with chemo either, however there where times my stomach did get upset an hour or two after treatment and I would take one but that very rarely happened

[Terri B]

Wow, so much food for thought!!

I kinda like the fasting idea. But what kind of fast? Nothing but water? Can I have a slim fast in there? Huh? I could do slim fast and water for days!

I called the onc nurse, and found out what i'm getting for pre-meds in the iv.

Kytril for the nausea-
Deximthizone
tagament
tylenol
benedryl

After i get drunk with the above cocktail, i guess then comes the good stuff.

MUGA yesterday turned out fine 61% was the preliminary reading. Did i mention, I HATE SCANS???

Love all you guys! MWAH!! :-*

[Sherryg683]

I never had any nausea and never did take the pills they gave me to take after chemo for nausea..not a one. Now they did give me decadron for the nausea in a drip before the chemo. It made me put on 10 pounds in no time but didn't make me sleepy, if anything it gives energy since it's a steroid. BUT...if I had to do it again, which I pray I won't, I would ask for a much lower dose of the decodron to see if I could keep the bloating down. I might even ask if I could skip the decadron and see how I tolerated it. I just didn't like bloating up like a balloon. I am like you, I never had nausea and have a pretty strong stomach. A couple of times they messed up and gave me Benedryl in my drip with my Herceptin and I was knocked out within minutes, slept all day. I wouldn't let them do benedryl unless you were showing allergic signs...sherryg683

[Bill]

Terri and Ruth, it's good to hear from you. I've been wondering how you are doing. Carla, Nikki's onc. just advised her to abstain from mega-doses of anti-oxidants. At first thought, and "common sense", it seems that eating a healthy diet rich in fruits and veggies would be fine, but after your comments, and the fasting studies (ok, I still haven't read them ) maybe that prior to chemo. and rad. treatments, if you eliminate as many anti-oxidants as possible from your diet (like fasting for 2 days prior) the chemo./ rads. kill more cancer cells. I feel that all of the "dots" are starting to connect. In another rant/post, I've gone on record as stating that I feel that the answers we are seeking to more effective treatments and/or cures to cancer(s) are right around the corner. We have so much knowledge and data already accumulated. I feel that discussions such as this play a role in helping to connect the dots. Sorry, Terri, I didn't mean to trample on your thread. Love and peace to you, Bill

[TSund]

Maybe someone has mentioned this, but daily Prilosec was very important to Ruth, she was miserable with acid reflux etc. for a couple days until she remembered she was supposed to be on it! It made all the difference.

Can't believe I didn't remember that one!

(thanks Bill :)

TRS

[abitjaded]

Oh yeah, prilosec or famotidine rock.

Carla

[Terri B]

Yep, I'm all about the daily Prilosec. Been doing that for years!

Well, I don't know the verdict yet, because I had my first treatment this morning. Call me stupid, or forgetful, or stubborn, but really, I FORGOT to take any meds before my appointment.

They gave me the kytril, the benedryl (which i slept off in about an hour) and the decadron. I feel really good now (pretty wired) and I know this is only the honeymoon phase.

I came to work this afternoon because I don't want to miss work if I feel good, yah know?

We'll see how the next few days pans out. Thanks to all of you for the great tips and stories! :))

[Terri B]

Oh and Bill,

Dang you're hot! You remind me of a taekwondo instructor I had once upon a time!

[abitjaded]

Hey Terri,

Decadron can be fun. Made me understand what my 14 yo son may be experiencing.

The good, the bad and the ugly.

Carla

[Terri B]

Really the only side effect i've had is from the Decadron i think. I have turned into a Bitch with turretts syndrome. I am picking fights with people (then apologizing when i realize it's the steroids) honking and flipping other drivers the bird, basically eating people for lunch. I NEVER act like this!!

I think it's pretty funny. :-))