Wednesday, 20 January 2010

Boldly tell your doctor everything

I tell it all now

There probably is a drug for every type of condition if you can articulate to your doctor exactly how you feel and your doctor is aware of that condition as to offer the best advice or medication to help with that situation.

During the time of my illness and the process of recuperation, I have learnt to be more open about the things I observe about my body, my feelings, my reactions and my comfort to my doctors, there is no time to be embarrassed about having to drop your pants and show them things.

With this kind of information, my doctors have sympathetically heard me and sometime adapted or modified my medicine to help me get better and feel better about the medication I use.

Healing the pain

The two areas where I have benefitted most from the management of my medication in relation to how I feel has been in pain relief and sickness manifested as vomiting.

I think by now we have gotten the reduction of pain down to just using an epidermal patch which I place on the skin of my belly that releases 25 micrograms per hour of Fentanyl [1] into my bodily fat over 72 hours.

This required a little adaptation, the patch itself can easily come off so my neighbourhood nurse gave me sheets of transparent plasters I could place over the patch to keep it fully adhered to my body – that advice came because I freely offered that information of discomfort not knowing there was an easy remedy to the situation.

Stopping the throw-ups

As for vomiting, that has been brought on by all sorts of things, it was first with the morphine in hospital, I was taken off that and given pills to handle the pain instead, soon afterwards a change in my medication brought on more vomiting that I had to take suppositories to reduce the nauseating effects. In fact, the suppositories are still part of my daily medication as an anti-emetic.

After my first chemotherapy, I had read up on the side effects and asked if I would have the anti-emetic pills for that particular chemotherapy, I was given something similar but by my fifth chemotherapy it was not as efficacious as before, I was so horribly sick for days unable to keep food down or take my medication.

So, at my last meeting with the oncologist, I mentioned this, it was important because it was on the basis of my saying I was tolerating the chemotherapy well that my dosage was increased from the initial 6 to 8 sessions and now after my fifth it looked like I was not managing it that well.

What the doctor ordered

The oncologist prescribed Emend aprepiant [2] which with the other anti-emetic medication I already use helps prevent chemotherapy-induced nausea and vomiting (CINV). It consists of three pills the first large dose to be taken an hour before chemotherapy and for the two days afterwards.

Apparently, it blocks the vomiting signals from the brain rather than from the stomach and I could almost say I feel the battle between my brain and stomach where I know I would not vomit even though there seems to be every inclination to want to vomit – the wonderful power of chemicals in the body.

Looking through the side-effects of using Emend is interesting because it literally has all the ones we know that chemotherapy sometimes causes like hair-loss, loss of apetite, itching and so on, but I must say, stopping the vomiting is probably the better trade-off in the circumstances.

As for drowsiness, well, I have been doing a good deal of sleeping all day, a good few of the pills do cause drowsiness in any case, but Emend is just what the doctor ordered – don’t be afraid to tell your doctor all the truth, it always helps.

Sources

[1] Fentanyl - From Wikipedia, the free encyclopedia

[2] Emend aprepiant

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