helpful suggestions for my mom first day of chemo (gem/cis)

Hi….my experience was that the side effects like nausea and tiredness didn’t really get worse each time…..that is, more severe, but they lasted longer. Instead of the nausea being maybe a couple days….eventually, by 4-5 rounds of the chemo, it was every day, including the third week, which was the resting week between infusions. The blood labs can go down and up, bouncing around during the whole time, but in general, the effects on the blood labs are also cumulative as well. For some people, the out of range labs hit fairly soon into the chemo, but for others, it isn’t a big problem until 3- 5 rounds and for some, it’s never really much of a problem at all. It just depends on how your body responds. Mine we’re significantly out of spec by round 3, but still okay to do chemo. By the end of round 5, the numbers all were entirely out of whack…with hemoglobin at 7 (and requiring transfusions) and platelets very, very low as were WBC and RBC, etc. I took one extra week’s rest between round 5 and 6 and that brought some of the numbers up enough to do round 6 and “I” felt better mentally about it…even though there were good enough at the usual week to do chemo. Even so, the oncologist did the round 6 at 75% solution….and it still knocked all the numbers into the tank again. At that point, thank goodness, I was done with the whole chemo thing anyway…..but I’m sure I would have had to have sat out more weeks if I’d gone on longer….no choices.

Serena,

The dexmethesone was added to my mother’s second treatment routine after she had a very rough time with the first one. Also added to her second treatment was a liter of IV fluids prior to chemo. It seems each doctor may have different protocols. What ended up working for Mom was-

Prechemo:
Zofran 16 mg by mouth
Dexamethasone 12 mg by mouth
Reglan 10 mg by mouth
EMEND 150 mg IV over 30 minutes

Prehydration- 1 liter normal saline over 1 hour

after chemo (Gem IV- 30 min/ Cis IV – 1 hour) there was another 1 hour liter of fluids with a few things added in it to help flush out chemo.

At home, on days 2-4, takes the steroid (Dexamenthasone).
Reglan- every 8 hours, Zofran every 6 hours.

They were long days, but we got into a routine and they always gave us a large cubicle since it seemed all the kids would stop in at some point during the day. Mom also did so well after they adjusted hospital meds and added steroid, that last few treatments she didn’t need the Reglan or Zofran at home.

I hope the vest keeps her warm!

Catherine

Serena, one more thing……don’t feel bad about not asking the questions when you are there at chemo. There’s a LOT of stuff to “take in” and I don’t think they expect you to remember it all the first time….or for some time after that for that matter. And….I think our senses are working overtime, just trying to “get through” the whole experience. As I said before….don’t hesitate to call the oncology office to ask your questions inbetween time. They’d rather you had the answers than sit and worry about it. You aren’t bothering them.

I had a little nausea a few days after the first tow rounds, then nothing later.

For me, the steroids wired me. I typically take a nap in the afternoon then I’m up all night – like until 6 or 7 am. ( I spend a lot of time catching up on posts here.)

(I’m the opposite of Julie.)

You definitely want to take the anit-nausea med before there is a problem. If I waited until I was nauseous I could not keep it down.

Your mom may develop a numbness in her toes (neuropathy). It’s not painful, but you should be aware it might happen. Amount depends on the person.

I always bring snacks. Aimee even goes out to the nearby ChicFila to get me chicken strips and fries while I’m in the chair.

You’ve got to drink lots of water to flush the chemo out. Try to get into the habit of getting a drink every time you pass a faucet. Room temperature flat ginger ale is also good.

When you get home, it might be easier to “graze” frequently on small amounts rather than taking large meals. You’ll figure that out.

Ditto on having something to do while in the chair. I read or go on-line with a tablet, or just rest with my eyes closed.

When I was on carbo/gem and later gem only, they used my veins. When I went to FOLFOX6 I had to have a port. One important thing about a port is the skill of the nurse preparing the infusion. Some have the “touch”, others don’t. When you find one who is good, insist on having that person in the future. It makes all the difference in the world.

Light-hearted attempt at humor.
Patient: “Doctor, after the chemo will I be able to play the piano?”
Onc: “Other than a little tingling in your fingers, you should be able to play just fine. Why do you ask?”
Patient: “I can’t play now but I was hoping that would change.”
ba-dump-bump ching

Duke

A couple more things:
When I got home after the day one chemo each round, I slept a LOT…..in the recliner…..and usually didn’t care to wake up to eat. I just wanted to sleep…with an afghan and not be bothered. By the end of day two, I was coming out of it…feeling a bit more alert and by the third day, I was feeling pretty decent again. The steroids and stuff they give you can make you jittery and not be able to sleep…just the opposite. I think I had one time I was up all night because I was so wired from the steroid. I just kept mysefl busy with genealogy on the computer…..but there’s always tv shows on all night…..or books to read or notes to write to people.

Hope that is of some help. I’m sure others will have some other ideas and thoughts to share.
Julie T.