Monthly Archives: June 2011

Chemotherapy – anti nausea drug options

One of the biggest factors in getting through this treatment , is the success , or otherwise in controlling nausea. Anyone who has ever experienced sea- sickness, knows just how depressing and debilitating it can be. Now imagine  sea sickness for weeks , then just when you start to feel better , going right back to square one- voluntarily!!

The good news is  lots of drug options to help, the bad news is everyone seems to react differently , so there is no one right answer. At first weren’t sure just how much it could be improved and thought that as long as he wasn’t vomiting constantly , it was as good as we could hope , but in fact , over the past few weeks have controlled it to a much better level, such that whilst still nauseous at times, never stops him eating and never results in actual sickness.

Over the past few months , this is our experience of the following  drugs

Steroids – dexamethasone , starts day before each treatment and continues for four days afterwards. These have proved really effective , seem to stimulate his appetite and keep nausea at bay really well. Their main downside is they do make him a bit hyper at night and disrupt his sleep as well as increasing restless legs syndrome.

Ondansetron – this is given intravenously during the day the chemo is administered, it appears to target nausea actually caused on the day and its immediate aftermath, apparently it works best in conjunction with steroids  and is a serotonin blocker. Again this seems to have been  really effective as nausea reduced in those first couple of days.

Metaclopramide – this has been the mainstay of our anti nausea controls  , normally starts day after the chemo treatment and is taken for round 5 – 9 days, it works by blocking the vomiting centre and encourages the stomach to empty , so that it gets rid of the heavy feeling you have when you feel sick. This had a lot of experimentation. At first we just took along with the steroids and stopped on the same day – this was a bad move as immediately started being sick the day after they stopped and although restarted them , never really got rid of the nausea at all. Also found  it was really bad first thing in the morning and during the night, when he was constantly waking up feeling sick and having to run to the loo, often just dry retching. As one of its common side effects is restlessness and muscle spasms , they didn”t help with the sleeping either ( not everyone gets same side effects of course )

Cyclizine – at round 2 when we said how bad the nauses was, they also prescribed this drug and suggested the metaclopramide was taken in addition for the first seven days. This is an antihistamine often used for sickness that combines well with other drugs – this one one didn’t work at all for him, still had sickness after the steroids stopped and same problems at night.

Levemopromazine ( Nozinan) – round 3 and  a new prescription to add to our growing medical chest . Again in combination  with metaclopramide, this stopped the dry retching in the morning , although had terrible effects on his moods ,  he veered between aggression and zombiedom.

Round 4 – here we found taking  metaclopramide for 9 days , but restricting it to morning and afternoon, at double the initial dose after discussions with the oncologist ,  reduced restless leg syndrome side effect and stopped actual vomiting but still left him feeling very nauseous for those first five days after the steroids stopped.

Round 5 – still taking the metacopramide, twice a day for the first 7 days, but supplemented with  levemopromazine at night . Strangely this time, the mood swings are much less, still can be a bit dopey during the day , but worth it as totally removes nausea at night , stops the dry retching and improves his sleep. Have kept this one going for a full two weeks and is best he has felt . looking to stop this now and go to no drugs other than the Folic Acid for the final week.

Fingers crossed same combination works as well  for round 6 .

Rainy days and blackbirds

Looking very tired, to be expected as this is the low point of blood counts, these should start to improve from next Tuesday as we enter the final build up week before round 6. Always a sign of low counts had very bad nose bleed today, been a while since these , but given low platelets number it takes ages to stop.

Sleep though has definitely improved , which makes a huge difference to his well being- no wonder sleep deprivation is used as a form of torture.

Avoiding bread has helped with the bloating, although digestion still a bit iffy. His self confidence is very low at the moment, as he is aware of how ill he looks. The local pharmacist didnt help , he collected his latest supply of supplement drinks, which are quite heavy but nothing major. As a grown man used to a physical job, found it a body blow to his confidence that she kept asking if was ok to carry them the 200metres to the car- kindly meant but as she was a gray haired granny herself made him wonder just how ill he did look.

As for the blackbird, the scruffiest bird in the world now not only visits the garden morning and evening , he taps on the window for you to go out and feed him. Heard this week on a gardening programme blackbirds are very partial to strawberries, so as a treat put one out for him- can categorically state while they may like strawberries this is only because there are no fruit cake trees available.

Getting to grips with chemotherapy

Had a really good couple of days, mainly because he has been able to get some reasonable sleep. This means he feels so much better during the day, no restless legs , no nausea and very few aches and pains. Still very lethargic and tired , so the afternoon black and white film has become a staple of the day , along with midsommer murders , but in his own words ” its taken a few months but think I’ve got to grips with chemotherapy”.

No more talk about not doing number 6 , now we just need to make sure blood count OK for number 6 on the 22nd June. Luckily not one of the prospective tube strike days which would have really messed us up – we thought we’d have to book an hotel the night before.

Talk is starting to turn to what he is going to do in terms of work , where we can go in August as we both need a break. How well he might be in July, so that we can do something. Have had my part time job offer through starting 1st September , so artmake the most of July and August.

With apologies to Bridget Jones

Sickness tablets – 1 ( v.good)

Weight – 67kilo ( good)

Hours sleep – 5 ( v. good)

Smiles/ laughes – 0 ( v. poor)

Glasses of wine – 2  (me not him ( good))

Chemotherapy continues to travel its course , now entering the bad flu stage , where all your body aches and no energy. Day routine is bed- couch – bed – couch , with occasional forays to the loo and the kitchen. On the up side nausea much reduced .

Ongoing search for drinks to reduce the chemo taste, Ribena now consigned to the orange squash, ginger beer dustbin of past phases. New ones on the block  are traditional lemonade and elderflower cordial. Our top five  food fads see chips retaining their number one position, toast is now a no go  but  a new entrant into number 2  by the rank outsider crumpets.

Chicken, tomatoes and of course carrots make up the top 5. Personally am disappointed to see chocolate eclairs didn’t sneak in this week.

A rainy day 6

Here we have typical start to June, sitting here looking out at the rain, watching Federer lost to Nadal in the French open. The scruffiest blackbird ever is our usual visitor, think he feels shortchanged with the stale fruit cake.

Fighting nausea and general lethargy all day, really in the middle of feeling so unwell, so he tends to feel emotionally at his lowest at this time. Difficult to get him interested in anything, acheiving more than a one word answer is a success, whole sentences at this time are a bit too much to hope for.

This normally changes over the next couple of days, although sometimes worry if it sets in for too long.

Just heard Federer called the elder statesman of the game at 29…. And realised am old enough to be his mother.

Chemotherapy round 5 – day 5

Wenceslas Hollar - The sword of Damocles

Image via Wikipedia

First day off the steroids and the usual decline. Very ill this morning, really nauseous and is hardly able to get out of bed, in fact just sent him back to lie down. Am sitting here watching Saturday Kitchen , wishing there was something I could do to help.

All I know is this does pass, he’d forgotten just how bad this first 10 days is, so is back to the “that’s it am not having anymore, you can forget round 6″. Hopefully by the time of the next appointment he will have forgotten again as the end will be in sight .

Of course it isn’t the end , it’s really just the start of the next stage , which is learning to live with sword of Damocles that is mesothelioma and a world of three month horizons.

One of the biggest challenges is going tobe finding him new challenges once he starts to feel better, have found another blog from the wife of a meso surviver which is excellent. They are both talented photographers and are now a couple of years after the initial diagnosis.

The mind can be your greatest weapon but also your greatest barrier , he’ll need a new focus so he doesn’t spend more time thinking about the disease than about life. Returning to his previous job isn’t an option and with his health record not sure how employable he is .

As he didn’t think he would survive long enough to have to worry about this think it’s a positive problem to have

link to the other blog

http://doingsomethingpositive.blogspot.com/

 

A dawn chorus

Chaffinch Fringilla coelebs

Image via Wikipedia

Word has got round in the local bird community about the organic red wheat, think the whole street was awoken at around 5 am this morning with the enthusiastic singing, robins, wrens, song thrushes, chaffinches, blackbirds….plus one green parakeet.

After the early morning start, work was also tricky, had one of those days when I was glad to be leaving. Then I opened my P 60 and thought..aaaaaahhh , how am I going to survive. Got the part time job offer in the post, and had another attack of the wobbles. Quick reassessment of priorities and remembered why this was all happening when he got up.

Today watching him lying on the sofa he looked so frail, I had a flashback of how fit and healthy he was last June and inside a small piece of my heart broke.

Then thought still here, still fighting , still a future however long it may be

Gluten free bread- the verdict

Irish Dancing

Image by wburris via Flickr

In summary, don’t bother. Difficult to describe , it looks like bread, cuts like bread and has a bread like consistency, it tastes nothing like it. Just made decision will wait until the chemo is over and go back to hovis.

Long day, tired but restless, so he looks shattered but his legs are constantly on the move, its like living with a demented Irish dancer. Appetite good though, made Gino D’Campo recipe tonight , which is basically chicken fried with garlic in a tin of chopped tomato with mozzarella on top , under the grill to finish. Very simple ,but really tasty , served of course with the now ubiquitous carrots and potatoes. Followed with some beautiful english strawberries and ice cream.

Have new visitor to the garden today , a tiny wren. No doubt tempted by my organic bird seed- was accidently sent a pack of organic wild red wheat that I hadn’t ordered. They told me to keep it, as I have absolutely no idea how to use it in cooking, the birds are benefiting from some wildly expensive hand picked wheat !

Last day of steroids tomorrow, so with luck agitation will subside and his legs can get some rest. No doubt whole new set of side effects will develop in its place.In fact looking at the list, think the only one he has missed is an early menopause.

Only one more pay check to go before redundancy- having a serious wobbly moment.

Mince and tatties again

This is honestly nothing to do with my limited cooking ability, this was by request. Spoke to the nutritionist ,who suggested plenty of potatoes if he was going to reduce bread and pasta because of the bloating,or he wouldn’t be getting enough carbohydrates.

Found out some of the best vegetables for carbohydrates are potatoes, carrots and sweetcorn , so guess what we also had for dinner, it’s as though we are following the reverse of a hollywood diet.

Also bought some gluten free bread and pasta, as nutritionist suggested this might be a good option- think the bread works out at about 50p a slice , so will be just for him at that price, I’ll stick with the bloaty bread.

Followed it all with strawberries and ice cream , so good evening meal, although as I had to be out for work today, he missed lunch and just had a suplement drink. At the moment nausea under control, although is very tired, doesn’t seem to matter how tired he gets , still finds it difficult to sleep. Am going to suggest relaxtion techniques as next option.

Good news from another meso warrier that their scan showed a really good result after the chemo, which has given us both a boost.

Watched springwatch again tonight – at some stage I stopped being hip and happening !!!