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Support > Patient-to-Patient > Patient Experiences & Guidance

Chemo support - tips and tricks

Karen, in addition to what Dave said, you'll likely get Benadryl with the Rituxan, as the later causes severe allergic reactions in many patients, worst the first time. But after I had my first dose and subsequent reaction (plummeting blood pressure with extreme dizziness which the nurses handled like clockwork), benadryl was part of my regimen, and it caused me to fall
asleep. So if you don't have really nice chemo-loungers, bring a pillow, and the type people use on an airplane, the ones that wrap around your neck, might be good.

CHOP causes nausea. Therefore, you'll likely get Kytril with it. Kytril is the best. Very expensive stuff, and the pill form, Zofran, was prescribed somewhat sparingly. With the rituxan first, your CHOP will be later in the day, and so will the Kytril. That usually was enough to get me through the night with no discomfort. That meant I started my 6 Zofran pills the next 
morning (2 days worth), which was better than running out at lunch. My experience was the first two days are definitely the worst for nausea, and with the Kytril/Zofran combo, were no big deal. Some have weaker stomachs, but I never barfed throughout my chemos. However, my second or third CHOP, probably day 3, I didn't take the Compazine (the cheaper stuff that followed the Zofran) before dinner and paid dearly. Follow Dave's advice and don't fall behind on your doses! It's way harder to catch up if nausea has set in. For me, it was akin to a really bad hangover but without the headache.

When I had my chemo and transplant at Stanford, they didn't prescribe Zofran nor compazine. Instead they believed that Ativan, an anti-anxiety med, worked best. I was highly skeptical, but it did work, and worked without all the "noise" of Compazine (which zoned me out). So ask your onc about that. Zofran comes in a version that dissolves under the tongue, very helpful if you feel you might toss. Same with Ativan. Under the tongue gets into your blood within minutes. It's amazing. But the Zofran is expensive and some of these choices are made (unfortunately) by your insurance coverage.

My experience with eating was some things tasted a bit weird, but I enjoyed food nearly as much on chemo as before. Everyone is different.

Prednisone is a really powerful steroid, and it does what most/all steroids do: messes with your moods. Emotionally, I was way more likely to get extremely triggered the week on P, including irrational anger, sorrow, etc. It makes your face flush and look puffy. Also increases your appetite. Most importantly, it keeps you awake, so it's best to take your second dose as 
soon as possible after your chemo day. For instance, I'd not get done with chemo until 4pm. Then to Walgreens to get my meds (new scrip every time) so first day's dose was at dinner. I'd still take day two at breakfast, not at dinner. Even then, you may need Ambien (sleep drug of choice, though I believe something new is becoming available now or soon) the week of chemo.

Your nurses in the chemo room will tell you most of this stuff. They may mention chemo brain. It's real. You get really stupid on chemo. Can't remember ANYTHING. Several other people I spoke to say it takes at least 6 months after completion to sort of get back to normal. Most of us agree we were sharper before, but then we would be sharper when younger in any case. If you go out to your car and can't find your keys, go back inside and look in your hand. That's where I usually found mine, though sometimes they were in my pocket.

I never had anyone drive me anywhere, but your results may differ. Definitely don't drive on Benadryl, but if that's before the rituxan and before the CHOP, it may be no big deal. I never wanted a visitor with me, as I often slept, day-dreamt, meditated, etc and having someone talking to me didn't make me feel better. I'd usually say, "Hope you'll excuse me but I need to sleep now" to the patient that was chatty. Once again, you may have a different experience and different needs.

Guess that's enough. Good luck! Dave's right, it's not nearly as bad as the movies make it out. At least for me it hasn't been.

Mark (CA) (originally posted on nhl-follic support list)
mixed cell follicular NHL stage 4
Dx 4/01 Tx 6/01-1/02 CVP x2, CHOP+Rituxan x8
technically "complete" remission 2/02
autologous peripheral stem cell transplant 6/12/02, CR

 
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