Question about Vomiting and Nausea after Chemo

ToughMama49

Hi All,

My mother aged 49 was diagnosed last month, she has started chemo with TCPH. 2nd session was over this Saturday. She was fine for 2 days (was on percocet) after the treatment and from yesterday she has been vomiting (3-4) times a day and pretty much is unable to eat anything solid or liquid.

She had a similar experience for the 1st cycle too and we had taken her back to the hospital,only for the doctors to keep her under observation and 2 days and tell us everything was fine and that this was expected.

What I would like to know from the folks here is, how long would this continue (Vomiting/Nausea) after each session? She was completely fine after about 10-11 days during the 1st round. is this how it is for most folks? What about the food intake ? Is it advisable to take anti-nausea meds for say even a week after chemo?

Please someone shed some light on this, I am really worried!!!!

Summer9125

Hi ToughMama49,

Sorry to hear about your mom, that sounds very uncomfortable for her. I don't know if my experience will help any, since I only experienced nausea and not vomiting, and thus I was able to eat solid foods, but I found that eating a few bites of sweet potato really reduced my nausea when combined with Zofran. However, obviously if someone is vomiting and can't eat solid foods, then this may not be a good idea - I don't know what the medical recommendation is when someone has vomiting, so please don't take my experience as a recommendation. For me, though, Zofran (anti-nausea med) just wasn't enough by itself. Even at the maximum dose, I had intense nausea, so that's why I went looking for other forms of relief. I complained to everyone (nurses, doctors) that my nausea was intense enough that I was gagging and miserable for several days after treatment, and it seemed to me from their responses that there was not a whole lot they could do if my nausea exceeded the medication's ability to relieve nausea. It really sucked. I did find another thing that worked for me, though, and that was to sit barefoot on the grass for about an hour - I happened to be reading a book on "earthing" and it seemed to help people with a variety of health complaints so I decided to try it for nausea and it definitely made me feel better. I'm sure there are other things out there, as well, but those were the two I found that worked for me.

Hope your mom feels better!

Best,

Monica

ToughMama49

Hi Monica2525,

Thank you for sharing your experience. My mom is unable to ear any kind of food solid/liquid, was unsure how long this lasts. Even the nurses/doctors don't seem to be bothered much as they say its normal and take meds for nausea/vomiting.
I just can't see her like this. I hope some one on this forum with similar experiences should be able to help.

Moderators

Hi ToughMama and welcome to Breastcancer.org,

We're so sorry to hear your mom is experiencing these very unpleasant side effects. While you wait for some more helpful responses from our other members, you may want to check out the following main Breastcancer.org site's pages for some tips:

• Treatment Side Effects: Nausea
• Treatment Side Effects: Vomiting
• Eating When You Have Nausea and Vomiting

We hope this helps and we look forward to hearing more from you soon!

--The Mods

SpecialK

This is not normal, she should not be vomiting, and her oncologist should be more proactive about controlling the nausea/vomiting. There are a number of anti-emetic drugs that can be tried (Zofran, Compazine, Ativan, Emend, Kytril, Reglan, Scopolamine skin patch, and Sancuso skin patch, etc.), and she may want to come back to the infusion center the next day or two for extra fluids with steroids - this usually helps. Some lingering nausea can usually be handled, but vomiting over the course of days will dehydrate your mom and really take a toll, not to mention potential weight loss. Wishing you both the best.

MinusTwo

Agree. There are plenty of really good meds that will control nausea & vomiting. Special listed several.

I also agree about additional saline infusions so she doesn't get dehydrated. I had diarrhea instead of vomiting, but I went between every treatment for saline infusions.

ToughMama49

Thank you both for your replies. We had taken my Mom back to the Hospital after the 1st Chemo, and as you mentioned they had given her Saline infusions, and she had felt better after that. Now after the 2nd cycle, we were unsure if we should take her everytime back to infusion centre to give her saline.

Doc says Nausea/Vomiting is common, but I am really worried HOW MUCH of it is tolerable? My Mom has vomited 3-4 times in the last 24 hours. I also am worried about the weight loss and the tiredness which accompanies that. How much of these anti-nausea meds is recommended? should we taken them whenever there is an episode?

Any further help on this would be greatly appreciated

SpecialK

The goal is to prevent nausea, treating it after it happens is more difficult and often does not work. Knowing her propensity for nausea/vomiting she needs to take these drugs prophylactically, most probably starting the evening of the same day as chemo, in order to prevent the onset of nausea. This was my instruction so that I had protection when the pre-med for nausea given by IV at the time of chemo wears off. I disagree with her oncologist - nausea is pretty common, but she should not be vomiting - there are a plethora of drugs available and she should be given another if the first one does not work. I came home with 3 different drugs, Zofran, Compazine, and Ativan, to try in that order. The Zofran was totally ineffective and it gave me a wicked headache, but the Compazine worked like a charm. After the first bout of nausea and vomiting after my first infusion I stayed with the Compazine and had no further problems, I never needed to take the Ativan. It is often a case of trying different meds to see which one works, but she should not be suffering like this. With many of these meds you can take them on top of each other if the first is ineffective, because they work by differing mechanisms. For more intractable nausea/vomiting she may require a time-release patch like Sancuso so she has better prevention. And by all means, bring her back for fluids on successive days - with each chemo infusion - this is a common practice,and she needs to remain hydrated. Drinking fluids and eating small bland snacks throughout the day helps also. Good luck!

ToughMama49

Thank you SpecialK, that definitely helps. You are right, she should not be suffering like this, and its very difficult for me to see my mother like this too. Will consult the Doc once again to get alternate meds.

ShetlandPony

ToughMama49, it sounds like it's time for ToughDaughter* to insist on better management of this nausea and vomiting. SpecialK has given you lots of good detailed info. Now if the doctor tries to brush you off, you must not take no for an answer. If necessary go above his/her head to the head of the department or whatever. Maybe there is a patient advocate or another doctor who will assist. Maybe your insurance company could help (they don't want to pay for complications from dehydration). Don't accept "we'll call you within 48 hours" either. Tell them your mom is suffering and is in danger of dehydration and needs help now. Be concrete, telling them exactly how many times she has vomited in the last x hours, exactly what she has or hasn't been able to drink or eat, etc. In case you can't tell, I'm hopping mad right now that the doctor has let this go on without offering more help.

*or ToughSon (I can't tell which you are.)

Momine

No, no, no, that is not acceptable. There are some rare patients who vomit almost no matter what, but in this case it sounds like poor management.

My docs put me on 4 different meds to prevent vomiting, one of them was Emend. They had me on a meds schedule for day of, and 2-3 days following each chemo. The idea was to prevent the vomiting from starting in the first place. They explained that it is better to prevent it than try to stop it once it starts. In my case it worked like a charm, although I was getting epirubicin, which is notorious for making people throw up. There were other unpleasant SEs from the chemo and from the anti-puke meds (headache from Emend and constipation), but I was able to eat.

ToughMama49

Thank you to those who took some time to explain what needs to be done. To provide an update, I had taken my Mom back to the Hospital, met the Onc and had multiple infusions given. There were still 2 more episodes despite the infusions, food intake is still minimal, but atleast she is rehydrated. Doc says, nothing wrong with meds, lets try prolly reducing the dosage of the 3rd Chemo cycle. Hopefully it gets better from here on.

MinusTwo

Like everyone else said - you have to PREVENT vomiting. Much easier than trying to stop it later. I took steroids the day before, the day of chemo & 2 days after chemo. I had Kytril added at the start of every single chemo infusion. I also had Zofran & Compazine in my bag, and even Emend, which luckily I didn't have to use.

Get the meds on board before it happens. Keep on taking them for a week. Don't stop just because there has been no vomiting.

Yes - get the doc to turn in orders for an extra bag of saline in between each chemo treatment. Dehydration isn't worth it.

Lisa123456

Short-term fasting before and after chemo results in significant reduction of side effects.

Here's the research: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2815756/

Good luck!

MinusTwo

I'm not sure where you are located, but if you can't get the doc to agree to the meds needed for prevention, you should probably go talk to your mom's PCP.

Legomaster225

Your poor mom! I just finished my chemo and nausea and vomiting were my biggest fear going in as I'm a puker! Thank God I had no nausea at all. My MO had my take zyprexa for 4 days beginning on chemo day for the AC part. I was able to cut back on that as it worked great but made me very sleepy. Also steroid, Emend and Zofran in my pre-chemo meds. For the taxol part I just had the I've zofran. Keep after the doctor. They need to try everything they can to make her comfortable.

https://www.cancer.gov/news-events/cancer-currents...

Hope they help her and the next round is better

lrwells50

I also don't understand the comment that they will cut back the chemo, if he hasn't prescribed meds for her to prevent the vomiting. I agree that if anti-nausea meds don't work, that should be next, but this doc seems to have a problem.

ToughMama49

Hi All,

Update: Doc says the reason might be that TCPH together might be overwhelming for a few and hence he wants to try varying the dosage to manage the side effects better. As far as the current bout of Vomiting goes, they have put my Mom on a course of Antibiotics (as they believe a stomach bug is causing this) and have given protein infusions with some other nutrients. The vomiting has come done, but still exists,Doc says in a day or 2 it should completely go down.

My question here is for the folks who have done/doing TCPH, how bad/good was the experience? Please enlighten me

MinusTwo

TCHP - the Perjeta is known for causing diarrhea. Otherwise I was weak. End result was some permanent CIPN (chemo induced neuropathy). The drug combo was much easier for me than AC, which I also had. There are several threads for TCHP which you can read.

Sorry but it still sounds like a run-around. Could you repeat where you live & where you are going for treatment? There is absolutely NO excuse for not prescribing generous anti-nausea meds

Make SURE that your Mom has steroid pills for anti nausea - like decadron - to take the day before chemo, the day of chemo, and at least one day after. Make SURE that they are starting each infusion with a top rated anti nausea drug added to the saline - like Kytril. Make SURE that you have Xofran or Compazine or comparable to take continuously after chemo for at least a week. With the severity & duration of her vomiting, I would also make sure I had Emend.

Remember - it's easier to prevent nausea than to stop it.

ToughMama49

Apologies, I guess I should have mentioned earlier that I am not from the US, and hence all the anti-nausea meds you mentioned may not be readily available to us, however an equivalent would definitely be available. Mom was given an alternate for Zofran (called Emeset) . The issue arose only 2 days after the chemo (first 2 days she had anti-nausea drugs as part of chemo as well as tablets) , and now doesn't seem to stop. They have tried giving these drugs as injections too, isnt working much.

lisabekind

Aloxi, and Emend in IV. My oncologist did not do this my first round with AC, and I was miserable. Those 2 drugs made a huge difference. Get Ativan (pills) too.

Tell you Doctor you want those 2 in your drip, no questions asked.

ToughMama49

Hi All,

Update : Mom is still in hospital, they had ordered an Abdominal Ultrasound, results showed nothing. However Blood work showed increased levels of GGT, AST and ALT (Liver profile test), all other Blood work is absolutely normal. Doc says this is normal and expected in Chemo. I am however worried not very sure about it as the Vomiting has still not stopped however its subsided, she is able to eat semi-solid food (albeit 3-4 spoons only at a time).

My question is, is it possible my Mom belongs to the minority who get a lot of side effects due to chemo? any more ppl like her who had a very bad experience from chemo? Only positive feeling now is that, the tumor definitely seems have become smaller after 2nd chemo(can only be confirmed after another scan which is scheduled soon)

NotVeryBrave

I had TCHP. I was on Dexamethasone starting the day before chemo, day of, and day after. They also gave me Decadron, Kytril, and Benadryl in my IV as pre-meds. I was instructed to start Compazine at home after the chemo and take it for a few days.

I have a pretty strong stomach and don't normally ever vomit. I did have some nausea occasionally while in treatment but never vomited. Your mother's case seems very unusual.

By the way - my chemo was reduced by 25% after the first round due to plummeting white cell counts that had me hospitalized. My MO said the dosages that are recommended are those that studies have shown >50% of people can handle. That may mean that 49% cannot tolerate it! Despite lowering the dose, I still had a great response.

jmayersf

I can't imagine my oncologist and team being so nonchalant about vomiting and nausea. Yes, while they are expected SEs, it would be totally unacceptable to me if someone didn't try moving heaven and earth to try to fix them. There is a long list of medications and other solutions (including medical marijuana which works particularly well for nausea). I would ask for a referral to Outpatient Palliative Care. Palliative Care is often confused with Hospice Care--but it is different. They work as a team (in my case a nurse practitioner and two MD's) who specialize in managing side effects related to chemo and cancer. I had problems with my GI tract that got totally resolved this time by careful monitoring. Indeed, there were checking in with me to see how I was doing and tweeked the meds based on my symptoms. If you can't get a Palliative Care Team, then I would demand a second opinion on her condition and to see what can be done. She is so fortunate to have you. And I hope you are able to come up with a solution quickly.

MinusTwo

Yes - or get a second opinion with a different oncology group. Or a third opinion. This is boarding on mal-practice. Don't put up with it!!!!