After Chemo Steroids....

Steroids
They told me the Dexamethasone (oral steroids) were for nausea, so I took them religiously before and after my chemo. I didn't have the side effects you describe, except I did have trouble sleeping for a couple of nights.

Steroids
Hi Susan, I've also experienced the same as you, red face and insomnia. I told my doctor that I don't really want to take any steroids but they said with some types of chemo you need to. So, I don't him, I wanted the lowest dose possible. It hasn't been too bad this time, the red face lasts about a day. I used to take a sleeping pill the night I received chemo, but found out that it didn't work because the steroid kept me up. But, just wanted to let you know, you're not alone.

Susan777 said:

B-12 Shot
The pills they give me to take for after chemo are steroids and anti-nausea. I have never taken any of them and have tolerated the chemo well as far as my Red and White counts. I am however sooooo very tired all the time. I am 14 days post chemo #2. I went to the store with my mom today and had to go sit down while she was checking out. My purse even felt heavy to carry. I eat good and take my vitamins. Has anyone ever asked about getting a B-12 shot? I wonder if it would bring my energy level up??? HMMMMMmmmmm????

B-12 Shot
Just noticed this question..... I was (and still am) getting regular B-12 shots every 3 months, I truly believe this stopped me getting neuropathy.
Michelle x

childofthestars said:

Steroids
Hi Susan
I was given the oral steroids to take on a reducing dose for 2-4 days post chemo (I had my chemo weekly). They were to help with any sickness. I didn't get the red face but I was like a lunatic on speed. About half way thru my treatment I only took the post chemo steroids after the double infusion of Taxol and Carbo. I don't think the steroids help with the bone pain (which I didn't get until about 2 months AFTER I finished chemo!!) but it's definately worth finding out.
Michelle x

I really dislike steroids.
I really dislike steroids. I had them before chemo but never after. They make me want to eat the wallpaper.

Carlene

MK_4Dani said:

Yep, the steroid are to
Yep, the steroid are to prevent possible bad reactions to chemo which to people who had those reactions say are very scary. It is standard protocol to take during infusion but I did not have to take after any post treatment. Knowing that I would not sleep the night of treatment I planned on watching TV: I watched several seasons of Grey Anatomy and other DVDs during treatment. Keep in mind as you go further into treatment the more fatique you will be feeling that will help with the insomnia. Maybe consider talking to doctor for Ativan to help with the sleeping. Ativan also helps with pain. Good luck with your treatments!
Mary

I worry that you secretly ignore your onc's prescriptions.
Does your oncologist know that you are not being compliant with the medication schedule he gave you? I think if you're not going to take something you were told to take, you should be upfront about that with your doctor. When you take massive pre-chemo steroid doses, you need to taper off of steroids gradually, not cold turkey. If he knows you have no intention of taking your after-chemo meds, he may make adjustments to the meds you get pre-chemo.

I always called the 3 days I took steroids with each carbo/taxol chemo infusion my 'hamster days' as I scurried around all night long with crazy artificial energy and had big red puffy cheeks. I never took the 'as needed' anti-nausea or pain meds with any of the (many) chemo drugs I had, but I am VERY compliant with anything I am told to specifically take on a set schedule. I whined to my oncologist about the sleeplessness the steroids gave me, and with some chemos (like carbo taxol) he explained that I needed the steroids to avoid possible allergic reactions,...but with some chemo drugs he cut WAY back on steroids or discontinued them all together since he knew how much I hated them. But I was always upfront about everything with my oncologist, disclosing all supplements, etc. I believe in self-care and self-advocacy, but you do have to factor in the knowledge your oncologist brings to the battle. At least give him a chance to explain WHY he wants you to take something, or maybe the opportunity to lower your dosage. ((((Hugs))))

Susan777 said:

Will talk to Doctor
Thanks for all of the input ladies. I will speak to my DR about not taking the steroids 3 days post chemo. I will also speak to him about a B12/6 shot to increase my energy level.

Thanks to all of you!

Susan

I should clarify....I was
I should clarify....I was never prescribed steroids, post-chemo.

Also, I have taken B12 injections monthly for years, because I have pernacious anemia. They did zilch for my energy level.

Carlene

carolenk said:

Differences in pre-med treatment
I was told the steroids are given to suppress the immune system and pre-empt a possible allergic reaction to taxol and/or carboplatin.

I have a feeling that it is easier on the chemo nurses and the patients in general to go ahead and pre-medicate ALL the patients with steroids rather than having a lot of drama going on with scary allergic reactions.

I asked my oncologist if I could NOT have the steroids at all unless I really needed them as I have a pre-diabetic condition and did not want to put my blood sugar way up. The doctor was OK with that but let me know that I was risking an allergic reaction by not taking the steroids. I guess I got lucky and never had an allergic reaction but it was my choice to take that chance.

@Linda--the "old thinking" about steroids was that they always needed to be tapered off--however, the "new thinking" about steroids is that there is no need to taper off when using a short term "burst of steroids."

This new thinking is the result of evidence-based medicine where practice is guided by research as opposed to "well, let's do this because it seems like the right thing to do."

On the other hand, when someone has been treated long-term (several weeks/months/years) with steroids (for asthma or an autoimmune condition), the adrenal glands go dormant and that's when it IS really important to taper off the steroids to allow the adrenal glands to kick back in again.

I was prescribed the post
I was prescribed the post chemo steroids. My nurse told me that because you are given such a large dose during chemo, taking a smaller dose post chemo helps to keep you from crashing as hard. It's just a smaller dose of the same thing. It was optional to take. I didn't take them for some of the same reasons mentioned here. It made me jittery and I couldn't sleep. I would try it and see if it helps or not. Anything that helps is worth doing when you're going through this, don't make it worse on yourself. For me the extra steroids didn't help but I did try them.

carolenk said:

Differences in pre-med treatment
I was told the steroids are given to suppress the immune system and pre-empt a possible allergic reaction to taxol and/or carboplatin.

I have a feeling that it is easier on the chemo nurses and the patients in general to go ahead and pre-medicate ALL the patients with steroids rather than having a lot of drama going on with scary allergic reactions.

I asked my oncologist if I could NOT have the steroids at all unless I really needed them as I have a pre-diabetic condition and did not want to put my blood sugar way up. The doctor was OK with that but let me know that I was risking an allergic reaction by not taking the steroids. I guess I got lucky and never had an allergic reaction but it was my choice to take that chance.

@Linda--the "old thinking" about steroids was that they always needed to be tapered off--however, the "new thinking" about steroids is that there is no need to taper off when using a short term "burst of steroids."

This new thinking is the result of evidence-based medicine where practice is guided by research as opposed to "well, let's do this because it seems like the right thing to do."

On the other hand, when someone has been treated long-term (several weeks/months/years) with steroids (for asthma or an autoimmune condition), the adrenal glands go dormant and that's when it IS really important to taper off the steroids to allow the adrenal glands to kick back in again.

Dex
For a minority of patients, perhaps 3-4 %, a serious allergic reaction is possible, which could land a person in the ER or worse! A further percentage have symptoms, such as facial flushing, although of lesser intensity. They want to be on the safe side, and give everyone high amounts of DEX, even though many people would have no problem with less. You are quite right that it also depresses the immune system. For this reason, I requested going on half dose for chemo #1, then, 14 mg for chemo #2, 6 mg for chemo #3, and 4 mg for the fourth session. (These amounts are total dosages, including some pre-tablets during cheno #1 and #2. If anything, each chemo session has resulted in fewer and fewer side effects. (But I have no idea why this could be the case)
As an "older person", I think my immune system needs all the help it can get!

carolenk said:

Differences in pre-med treatment
I was told the steroids are given to suppress the immune system and pre-empt a possible allergic reaction to taxol and/or carboplatin.

I have a feeling that it is easier on the chemo nurses and the patients in general to go ahead and pre-medicate ALL the patients with steroids rather than having a lot of drama going on with scary allergic reactions.

I asked my oncologist if I could NOT have the steroids at all unless I really needed them as I have a pre-diabetic condition and did not want to put my blood sugar way up. The doctor was OK with that but let me know that I was risking an allergic reaction by not taking the steroids. I guess I got lucky and never had an allergic reaction but it was my choice to take that chance.

@Linda--the "old thinking" about steroids was that they always needed to be tapered off--however, the "new thinking" about steroids is that there is no need to taper off when using a short term "burst of steroids."

This new thinking is the result of evidence-based medicine where practice is guided by research as opposed to "well, let's do this because it seems like the right thing to do."

On the other hand, when someone has been treated long-term (several weeks/months/years) with steroids (for asthma or an autoimmune condition), the adrenal glands go dormant and that's when it IS really important to taper off the steroids to allow the adrenal glands to kick back in again.