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, 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 sometimes 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 benefited most from the management of my medication in relation to how I feel have 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 body 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 the hospital, I was taken off that and given pills to handle the pain instead. A change in my medication brought on more vomiting, so I had to take suppositories to reduce the nauseating effects. In fact, the suppositories are still part of my daily medication as an antiemetic.

After my first chemotherapy, I had read up on the side effects and asked if I would have the antiemetic 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 based on my saying I was tolerating the chemotherapy well, that my dosage was increased from the initial 6 to 8 sessions, and no,w 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 appetite, 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

No Gloria in Emesis

Warning: To be read only by those with a strong disposition, it is full of talk of emesis, sickliness, vomit and puking.

Tired out completely

It was a hard slug getting home on Monday evening; I think I had tired myself out after chemotherapy, the long walks and the visit to the library.

A few chills had set in as I trundled to the tram stop just in time to catch the tram going home. I was homing for bed and not long after a snack, I was under the duvet and ready for sleep.

I was out for just over 2 hours and got up for my elevenses, well, I take my pills twice a day, though only one set has to be taken every 12 hours, there are 5 sets of pills, the other 4 are taken daily and I have split them into the morning set and the night set.

This regime is easier than when I first left hospital with pills to take 6 times, 4, times, 3 times, 2 times and once a day – it called on all your powers of organisation to sort out.

Then there is the emetic suppository to be taken as needed, an anti-constipation powder to be mixed in water and taken for the Fentanyl pain patch that gets changed every 72 hours.

Puking all the time

This was the first time that my chemotherapy session and pain patch change coincided and this probably lead to the sickly feeling I had throughout Tuesday.

Just before my first elevenses, I was feeling quite nauseous so I went over the toilet bowl and threw up violently but nothing of substance came through, the feeling continued all day, I could hardly eat and really could ingest no medicines in that condition – I took the anti-emetic suppository hoping it would alleviate the situation but it seemed like a long shot, I was on the verge of calling the hospital.

During one of the 5 times that I was sick, I was in the middle of a telephone conversation literally answering back between each puking session, it was an absolutely rotten feeling.

Neighbours bring strength

I settled back in bed and more or less spent the day lain down and hoping for some improvement – afterwards, I found that my neighbours had returned from holiday, we had a chat and as usual they were there to help and the first thing I could keep down was some bouillon they made for me.

I gained a little strength to do some shopping, had some fruit and when it came to my nightly elevenses, I took the anti-emetic medication which also comes in tablet form along with my main medicine and the suppository.

What a day, glad it is over, thanking God for His mercies and looking forward to another day – it is white outside – it has been snowing again after the complete clear-up on Monday.