Nausea. Just the word makes you feel it, doesn't it? The scary thing is that we can be grateful to be living in the golden age of medicine. Zofran and Compazine make it so that nausea can be easily managed. Very few people have to be as sick as our predecessors were. I know that I am always giving thanks for my Compazine supply!
The largest problems I have experienced with nausea are those of association. You know what I mean...you went to Denny's after a treatment so now whenever you smell greasy eggs you feel just the slightest bit queasy? Or when you smell the alcohol pad to sterilize your skin you feel a little bit "off" when they haven't even started the IV yet? Some people say they feel a little sick just driving by the doctor's office.... There isn't much that can be done about this except to remind yourself that nothing has happened to make you sick. The feeling generally passes pretty quickly.
We all wish that all nausea were like this but it isn't. So, in the meantime here is a little bit about nausea and ways to deal with it:
Nausea is not in your tummy like you've always thought. No, it's all in your head. Really. There is an area called the "chemoreceptor trigger zone" or "CTZ" that causes nausea. Seems appropriate to me: chemo and nausea, chemoreceptor and nausea. As it turns out, the chemo part of chemotherapy triggers the chemo part of CTZ by getting your body to release natural chemicals like dopamine and serotonin that stimulate the feelings of nausea.
Say hello to your favorite drug and mine, Zofran. Yes, that is why you get a Zofran drip before they give you the chemo drugs. The Zofran is supposed to trick your CTZ by blocking the release of the natural chemicals and to help your digestive track empty faster preventing the feeling of fullness which can trigger the CTZ. It may be wise to eat a small meal (but do eat) rather than a large one after chemo to help prevent this aspect of the body function.
Compazine has been around for over twenty years. It is a dopamine blocker. It is available in many different dosages, and types; I get the 15mg spanules and take them every 6 hours as needed. Generally I start about 3 hours after chemo and take them for about 2-3 days. Longer when I'm on the ABVD than on the MOPP.
Side effects include drowsiness (when combined with ABVD do not drive and plan to sleep for about 15 hours a day), sometimes dizziness, and sometimes restlessness (I have this problem if it is hot out. I just can't sit still.).
One thing to remember about the Compazine is that you need to take it at the first twinge of nausea. If you wait until you really think that you are going to be sick you are going to wait too long. You have to allow the drug time to interact with your body and work.
Zofran has been the saving grace of many a chemo patient since its introduction in 1991. It is similar to Compazine in it's function: its job is to prevent the release of serotonin. It is extremely effective in preventing nausea from even the harshest chemo drugs. It is worth every penny you pay for it. Supplemented with Compazine you should have very few problems at all.
Another bonus of Zofran is that it has very few side effects, if any. It doesn't cause the restlessness or sleepiness (although I feel dizzy when it gets dripped into my port-a-cath). HOWEVER, this drug does sometimes cause constipation or mild headaches. A balanced diet and Tylenol should allow you to reap the benefits of the drug without much of a problem with these effects, however.
There a re a few things that can help to avoid nausea in addition to taking the drugs, and after you stop taking them. These include:
1) Eat smaller meals 5 times a day rather than 3 large ones. This will prevent you from eating too much and getting that "too full" feeling talked about earlier.
2) Eat bland foods that won't upset your stomach: mashed potatoes, ice cream, crackers, cream soups, etc.
3) If you are sensitive to smells stay out of the kitchen while food is cooking and eat cold foods like salads and fruit that won't have the strong smells that meats and sauces might.
4) Liquid intake is very important but some things may not taste right. Try drinking warm 7-Up and ginger ale if you are nauseated, water, and clear juices. Juice popcicles are another way to get juice without having to drink liquids.
5) Open windows to make sure the air is fresh. Mild exercise such as an easy walk may also help.
When nothing seems to be working, I have found it is best, to a) admit that I feel awful, b) put a cold washcloth on my forehead, c) get a warm, flat ginger ale, and d) lie down and still. Sipping, not drinking from the ginger ale is recommended. If you drink from it too quickly you will get that "overfull" feeling that you want to avoid. Sipping will settle the stomach. If you can, sleep. When you wake up, with any luck, the Compazine will have done it's job and you will feel ok again. Keep on top of the Compazine schedule for the next day or so and you should be ok.
Copyright 1996, 1997. Last updated May 28, 1996.