“I just wish I knew that this was a possibility and I would have sought out help sooner.” This was the text I received from a friend going through chemotherapy. She was suffering badly from the side-effects. “I keep saying I’ll wait one more day because it must be getting better…”
Her text went on, “It’s hard to know how long this yo-yo program will last.” Yo-yo program? I assumed she was referring to feeling sick, then feeling well, then back to sick. With a few questions, she provided additional information, “They’ve tried Gravol.”
I nearly spat out the coffee I was drinking. Gravol? Gravol!! I was irate. Gravol is for motion sickness from car rides, roller coasters, or airplanes. Gravol is not a suitable answer for nausea caused by chemotherapy.
Well-controlled side-effects from chemotherapy should not cause a yo-yo program. One should not feel sick, then well, then nauseated again. Patients should not accept being sick as par for the course. Medical teams have enough anti-nausea meds that if one is not working, they can try something else to manage the symptoms and side effects of both the cancer and the treatment.
Regardless of the time of day, I had a number to call and reach out to receive help from.
If you’re a cancer patient and experiencing vomiting, reach out for help. Contact your oncologist. Contact the after-hours emergency help number you’ve been given. Contact the pharmacist who works with your medical team. Do not wait until your next appointment with your team; get help in a timely fashion.
I remember sitting in my oncologist’s office and the nurse was explaining the side effects of R-CHOP chemotherapy. She described it as being a combination that was well tolerated. She prescribed two anti-nausea medications that I was to take preventatively to stop the nausea before it started. She also prescribed one anti-nausea medication that I could take if I felt unwell.
Whenever I have had chemotherapy, I always took the prescribed anti-nausea medication as directed by my nurse. The first day of RCHOP was no different. I had breakfast, ate my preventative anti-nausea medications, and headed to the hospital. After my first dose of R-CHOP I went home and straight to bed. I awoke a couple of hours later. Something did not feel right; my stomach was woozy. I took the backup anti-nausea medication. Two hours later, things were still not feeling great so I took the second dose of nausea-preventing medication. Roughly two hours later I found myself vomiting into my toilet. I crawled my way back to bed and hoped it would end. It didn’t.
Around 8 p.m. that evening, I knew things were not settling down. I felt terrible. My stomach was in knots and I was curled in the fetal position. Opening my eyes caused pain. My head hurt and I could barely think. It was then I made a decision. I knew I did not want to spend the night feeling like this. I knew the closest pharmacy would close around 10. I knew I needed different medication. I called the emergency helpline that my nurse had given me and briefly explained who I was and that I needed a prescription for additional and stronger anti-nausea medication. I let the nurse on the other end know that my husband would take over the call as I was so sick that I was unable to continue talking. My husband filled the nurse in on the details and we were left to wait while the nurse got in touch with a doctor and then had the prescription sent to the nearest pharmacy that was open until midnight. She called us back and let us know that all had gone according to plan and my husband could go and collect my medications.
From the time I dialed the emergency helpline to the time I had the new medication in my hand was roughly four hours. It was an agonizing four hours. I took the new medication and passed out cold. Thankfully I stayed that way throughout the night. The next day I was tired and felt out of sorts, but I was no longer nauseated. Mission accomplished.
As a cancer patient, you continuously need to advocate for yourself. I’ve had 5 different combinations of chemotherapy in the last year and a half - ABVD, R-CHOP, GDP, BEAM, and most recently Fludarabine paired with Cyclophosphamide. Whenever I started a new type of chemotherapy, I let the nurse and pharmacist know that I got sick and that I HATE vomiting. They were always fantastic and together we created a plan to manage the nausea. I always had multiple preventative anti-nausea medications and multiple anti-nausea backup medications on hand in case I felt ill.
Whether you’re struggling with nausea or with some other side-effect, knowing when to seek help is the key to staying well and recovering. It’s also a question every human struggles with at some point in their life. Knowing when to get help is a complex question to answer. We often think we don’t need help because if we just wait it out, it’ll get better. But with chemotherapy and other aspects of life that is not always the case. Just because you feel like you’re at the bottom or lowest point doesn’t mean you are. With uncontrolled side-effects from chemotherapy, it can always get worse. Get help to stay strong. To get through treatment you must STAY STRONG.
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