Category Archives: anti-nausea

Do you think the chemo is working?

“Do you think the chemo is working?” was the question my wife posed to me last night. This question was based entirely on my not suffering any violent side-effects from the chemo. My wife’s thoughts seemed to be posited upon some old Victorian (which she most definitely isn’t) philosophy along the lines of , “the worse it tastes the better it is for you!”

In all honesty I’d expected the worst. I’d prepared myself to be spending huge amounts of time hugging the toilet or the washbasin, or possibly both! In fact that hasn’t happened at all. For most of yesterday I knew I was having some sort of problem with my stomach/bowels but where and what wasn’t quite clear to me so I was prepared for anything to arrive from anywhere at any time as it were! Happily nothing did arrive unexpectedly. Last night was the first time I’ve not taken anti-nausea pills since I started chemo. I have 30 of the six hourly kind to be taken at need, and I have to admit I was tempted to take one before going to bed just to obviate the need, but I wanted to know what was going on with my body, so I didn’t, and, happily I got a good night’s sleep – well I got as good a night’s sleep as my wife’s cat would allow wakening us at around 2.30 a.m., 4 a.m. and again at 6.30 a.m. Did it want anything? Well, not from me!! Anyway the point is I wasn’t nauseous.

So I’ve had no nausea, no diarrhoea (a word which seemingly 90% of people give up on ever trying to spell correctly), mild constipation and not much else apart from fatigue, so you can, perhaps, see why my wife was wondering whether I’d been infused with the right stuff.

The fatigue is very strange. It’s almost as though my body clock has slipped somewhere. From arriving in the US in April 2011 I’ve kept reasonably traditional bed-times (generally somewhere between 11 p.m. and midnight) but since my first chemo infusion on Tuesday I’m wide awake at that time and then want to sleep on deep into the morning. Once I’m up and awake then I seem to be OK for short periods of time but then my attention just disappears though I think it is coming back. A few days ago I was able to read only a couple of sentences at a time in a book whereas now I can generally make a whole paragraph at one go. If I’m reading in bed I don’t find myself dropping to sleep while reading, but I do find myself wakening up with a book in my hand. The whole fatigue thing is, as I said earlier, very strange. Last night I was able to watch three episodes from The Big Bang Theory (surely the best comedy on t.v. at the moment) without losing focus once, or at least if I did lose focus I didn’t notice, but today, watching my “top team” Spurs beating Newcastle United 5 – 0, I zoned out after 10 minutes of the second half, went to bed and slept for an hour! In the 50 odd years since I adopted Spurs as “my top team”, how many chances have I had to watch them stuff five past the opposition and then, when I do get the chance, I fall asleep! Marvellous! Actually the most goals I’ve ever seen scored by one team in a professional match was at Oakwell when Barnsley FC played a touring side from Africa and, if memory serves, scored 10 goals. I don’t ever remember the Reds doing anything so extravagant ever again!

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Filed under anti-nausea, Cancer, chemo, chemotherapy, nausea

It’s a small world

So, it was Tuesday the 7th when I received chemo, Wednesday the 8th when I was tempted to think, “I don’t know why people go on about this, I feel fine”, and then Thursday the 9th when I just bombed and spent most of the day either sleeping or dozing. Eventually I pushed myself to get out of bed around 7 p.m. but I was definitely, totally, “out of it”. Walking required concentration. As each sole groped for the floor it was as though I was experiencing the touch through several layers of cardboard. Walking more than four or five steps left me needing to stand still for a few moments, or to sit down. For much of the day I felt queasy, not nauseous, just queasy, and I was far from sure whether or not this was the beginnings of nausea from the chemo, or just the consequences of not having put much food into my stomach for three days. I think it was just the empty stomach.

Today I awoke feeling much more like myself, got up and had breakfast before 7.30, and then went back to bed to doze some more. As the time approached for my 12 hourly anti-nausea pill my stomach once again began to feel queasy. Was the queasiness simply because I knew  that the next pill was due, or was it the build up to my first, racking, bout of chemo-induced vomiting, or, once again, was my stomach simply in need of food? Well, I’ve taken my pill, eaten, and, the queasiness has passed, and I have no way of knowing what caused it to do so. This was the last of my twelve hourly pills and, I have to admit, I don’t know whether or not to be glad about that. As I understand it, I’m now through the period when I was most likely to suffer chemo-induced vomiting, so I should have no need to be concerned, but, obviously, a change of medication might mean that I now start to experience the vomiting and I am a wuss!!

Yesterday I had the concentration span of a day old baby, actually it might have been considerably less than that, and, although today is a considerable improvement I am aware that my ability to stay on task is limited to a couple of minutes at a time.

The feeling of being isolated and confined to the house and its immediate environs started yesterday and continues today. The latest post from oldermanyoungerman  perfectly captured my feelings when he wrote “My confinement with cancer over the past six months, walking from bedroom to bathroom to computer room to the small outdoor patio and back to the bedroom…has made my world small.I can feel my world contracting moment by moment. 

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Filed under anti-nausea, Cancer, chemo, chemotherapy, Hodgkins Lymphoma

Another change in diagnosis!!

Well the results of the second opinion by Dr Jaffe of NIH Maryland were back with my oncologist Dr Jason Tache today when my wife and I arrived for my first chemotherapy infusion. Dr Jaffe’s opinion is that the cells previously identified as +20 are actually -20, which meant that my oncologist, Dr Jason Tache, decided not to include the Rituxan in my personalised cocktail of chemotherapy drugs aimed at killing this cancer as quickly as possible. The diagnosis is now Lymphocite Rich Calssic Hodgkins Lymphoma, so I’ve gone from having a rare cancer to having the second most common – I suppose that’s good news – well probably. The less good news is that I’m now classed as stage 2B lymphoma rather than 2A. From what I’ve read and been told this isn’t really likely to make any difference to my treatment or recovery. The significance of the change of diagnosis to Lymphocite Rich Classic Hodgkins is that Rituxan wouldn’t make a proven improvement to the chemo cocktail but would have side effects, so, the logic goes, why impose potential side effects when there is unlikely to be any gain? This position means that Dr Tache could not, in conscience, use the insurer’s approval for eight treatments at a cost of around $8,000, and presumably thought that if he were to do the professional thing and notify the insurer of the change of diagnosis, then the insurer would cancel the authorisation. Do I trust Dr Tache’s diagnosis? Yes, absolutely, he strikes me as a very knowledgable and professional man. That level of trust was supported by the comment of one of the nurses that the doctors at this particular centre are world class. That’s certainly good enough for me!!

So, the chemotherapy itself went well. The nurse who worked with me was Lisa Doyle-Frank and I cannot commend her enough. She was friendly, supportive, professional, available and informative. Lisa was there the second that I showed any sign of needing her and very willing to leave paperwork to come and support me. Lisa was also really good at giving my wife information. Not to leave out the other nurses in the chemo room, I just don’t know their names – they were all very friendly to me and the other patients who pass through the room on their way to good health. There is a feeling of professional enthusiasm and good humour in the room which was tangible from the moment I walked in, and believe me, that atmosphere feels very good and is very, very reassuring. The relationships between patients and nursing staff were obviously excellent and I felt very secure.

Lisa approved of the quality of work performed by Dr Todd Schwartz, the interventional radiologist who implanted my “port” that comment was also very reassuring! After watching Not as I Pictured: Lymphoma and hearing the comments of John Kaplan about how painful the hook was as it was pushed through his skin and into his port, I was expecting the worst, but it wasn’t at all bad. Yes, I felt Lisa push it in, but I have to say I’ve had more discomfort from IVs pushed into a vein. Lisa started off by giving me a sedative just to relax me and boy did it work! All I wanted to do was sit back, close my eyes, and bring on the rest of the treatment! I wasn’t out of it by any means and I was able to join in the conversation when I wanted to, but I was very, very, very relaxed. After that came a test sample of bleomycin, just to make sure that there was no reaction. After the rest of the drugs were administered through the drip into port there had been no evident reaction and so Lisa gave me the rest of the bleomycin dose. After that we were done, a quick chat with Dr Tache to let him know that my wife had spoken with the insurer today and they had confirmed approval of the Rituxan should he at any time change his mind and decide it should be incorporated, and we were done. The advice from Dr Tache was to eat soup just in case I should suffer nausea. The advice of my wife’s pediatrican friend Henry, who has survived cancer himself, was that I should avoid eating my favourite soup! No, I don’t want to explain why he gave that particular advice!!! Anyway we decided that, before my immune system gets suppressed, we would have one last meal out so it was soup for me at Denny’s, and very enjoyable it was. During the “meal” I wasn’t sure whether or not I felt nauseous because of the chemo or because my stomach was empty after not having eaten for around 10 hours. Happily it turned out to be the latter and, so far, I’ve not been nauseous. Lisa thinks there is a good chance that I will not be nauseous at all and I want to believe Lisa is correct! Actually Lisa did say that it is often the second day after treatment that nausea hits but another lady in the chemo room said that it’s usually Saturday when she feels nauseous after a Tuesday infusion, so, I guess, it’s just a case of wait and see and hope the anti-nausea pills I have for the next three days will work and I won’t need to start using the back-up pills for the week afterwards.

Anyway it’s been a long day and midnight has just slid past while I write this, so I really ought to take the first of my pills, which may make me drowsy, and take myself of to bed – to dream perhaps!

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Filed under anti-nausea, Cancer, cancer stage, cancer staging, chemo, chemotherapy, Dr Elaine Jaffe, Dr Jason Tache, Dr Todd Schwartz, Dreams, Health Insurance, Hodgkins Lymphoma, John Kaplan, Lisa Doyle-Frank, Not as I pictured