Chemotherapy Survival Guide: Dealing with Nausea

Here are some suggestions to help you get through your chemotherapy treatment. By preventing nausea you can be comfortable, stay well nourished, and feel better sooner.

BEFORE TREATMENT

It’s not necessary to have an empty stomach before getting chemotherapy. Staying well nourished and well hydrated (drinking lots of fluids) will help you feel stronger and help your body eliminate waste products more quickly. Eat and drink regularly until about two hours before your treatment. Eat foods that are easily digested (high carbohydrate, low fat). Stay away from spicy food or food that will give you a lingering aftertaste that may make you feel nauseated later (onions, garlic, and so on). Your doctor may want you to take anti-nausea medicine before coming to the clinic or hospital.

DURING TREATMENT

Do whatever you can to lower your anxiety. Bring a book, music, a CD, or a friend to occupy you while you’re waiting for treatment. Some anti-nausea medicine might make you feel sleepy, so sleeping through longer chemotherapy treatments might be possible. Wear comfortable clothes, loosen your belt or tie, and bring a sweater or ask for a blanket if you feel cold. Some chemotherapy drugs leave a metallic or unpleasant taste in your mouth, so sucking on hard candy or chewing gum might help.

AFTER TREATMENT

There are a number of things you can do to prevent nausea during the first few days after treatment. It’s important to let your doctor or nurses know if you’re experiencing unrelieved nausea or any troublesome side effects from the chemo or anti-nausea medicines, or having difficulty eating, drinking, sleeping, and so on.

+ Medications

Start by taking the medication in the dose and frequency recommended. For instance, if you’re getting a kind of chemotherapy that has very little chance of causing nausea, your doctor might recommend taking nausea-relieving medicine only if you experience that problem. Be sure to let your doctor know how often you needed it and whether it was effective.

If you’re getting chemotherapy that’s more likely to cause nausea, you may be given both nausea-blocking and nausea-rescue medications to take at specific times for the first few days after treatment. Then there may be a different combination of medicines that will relieve delayed nausea if the problem continues.

Be alert to any side effects that may occur, and notify your doctor or nurse as soon as possible if you have any problems. Remember, everyone has his own unique responses to treatment and to the anti-nausea medicines. Your doctor needs your feedback to make adjustments in the plan so that it works for you. You may need to change to a different medication. You may need to change the schedule, the dose, or the frequency of the medication, or you may need to add another medication to counteract a bothersome side effect.

+ Food and Fluids

Eat small amounts, more frequently. Avoid feeling overfull. Eat bland foods (mashed potatoes, cottage cheese, toast, sherbet, crackers).

You may be very sensitive to the way foods smell. Foods that are served cold or at room temperature have fewer aromas. Stay out of the kitchen as much as possible. Prepare dishes for yourself or the family that are quick and easy with minimal sights or odors that may upset you.

If you’re diabetic, you have to be careful that the medication you take to control your blood sugar is appropriate for how much you eat. You might need to check your blood sugar several times on the day of your treatment to make sure it doesn’t get too low or too high. Your doctor may want to adjust your insulin dose or other blood-sugar medication until you can eat normally.

Sometimes sweet juices are hard to tolerate after treatment. If that’s true for you, try lemonade, broth, club soda, or ice water. Try mixing a little juice with mineral water. You might need to try several different kinds of tastes before you discover what works best.

It’s most important to drink fluids. Don’t worry if, at first, you don’t feel like eating solid foods. Try Popsicles, tea, juices, soup, soda, watermelon, or ice. Drinking with your meal may make you feel overfull and bloated, so drink fluids before or after eating solid food. Drink small amounts of fluids frequently to avoid feeling too full. Rinse your mouth or brush your teeth before and after eating to avoid lingering tastes that may be nauseating.

+ Activities

Fresh air and mild physical activity help prevent nausea. Take a walk or sit on the porch or by an open window. Distractions may help. Go to the movies, read a book, talk to a friend, listen to music, or play cards.

+ Sleep

Some anti-nausea medications may make you sleepy. If you’re supposed to take a medication on a set schedule during the day, you may want to set the alarm clock so that you can wake up, take the medication, and then go back to sleep. If you aren’t scheduled to take anti-nausea medication in the middle of the night, then take it when you first wake up—before you get out of bed and start moving around.

+ Relaxation

If you feel anxious, relaxing may be easier said than done. There are a number of CDs and DVDs that you may find useful to help you clear your mind and relax every muscle in your body. You may find that the tension you hold in your face and jaw or in your shoulders or abdominal muscles is adding to your anxiety or feelings of queasiness. Some CDs or DVDs provide peaceful and relaxing images and music. After you practice with these aids for a period of time, you may be able to relax yourself very quickly with or without them anytime you feel tense or anxious.

+ Self –Talk

The things you say and think to yourself can either help you cope or cause you more stress. Many of these thoughts are unconscious and so automatic that you may not even be aware of them. Pay attention and try to tune in to what you may be saying to yourself that increases your stress and worries about nausea (or any other scary symptom). It may help to write these thoughts down. This makes them more conscious and more manageable. It also allows you to argue against them and replace these anxiety-provoking thoughts with thoughts that are supportive, accurate, and focused on coping.

Your anxiety-producing thoughts may sound like this:

• I can’t stand it; this is too much.

• I feel so helpless; there’s nothing I can do.

• The anti-nausea medicine isn’t working; nothing will help.

• I’ll never feel any better.

You can replace these anxious thoughts with supportive thoughts that help you cope:

• I can get through this. The discomfort will only last a few hours.

• If this medicine isn’t working to relieve my nausea, there are other medicines that I can try.

• The chemotherapy is effective, no matter how nauseated I feel.

• I’m learning how my body reacts to chemotherapy and to the anti-nausea medicines.

• I am in charge; I can take the medicine that I need in order to feel better.

• It’s okay to sleep and let the hours pass.

• The kids (or spouse or job) are taken care of for now. Right now I can pay attention to me and take care of myself.

• I know how to relax, distract myself, and feel better.

• I know that is here for me if I need him or her.

Write down your own coping thoughts. When you find your anxiety rising, tune in to what you’re silently saying to yourself and talk back, using the coping statements that help you feel better.

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Excerpt from: THE CHEMOTHERAPY SURVIVAL GUIDE, THIRD EDITION: Everything You Need to Know to Get Through Treatment (New Harbinger Publications)