newbie needing info on oxaliplatin
My husband was recently diagnosed with stage IV colon cancer with 5-6 mets on his liver. If fact we are still in the hospital recovering from surgery to remove part of his colon. He is to start treatments mid Jan. His Dr has recommended oxaliplatin with 5-FU. He says he has had good results with this treatment and the side effects are manageable. What can we really expect? Any advice? We are feeling a little overwhelmed and anything would be helpful.
Thanks,
Tina
Comments
-
been there, done that.
Sounds like right where I was last year. Husband had same diagnosis and tx recommendation.
He was stage III. Had the 5FU and Oxy. Side effects were neuropathy in fingers, cold sensitivity, (don't let him drink anything cold.) Keep away from the refrigerator without gloves. Some days diarrhea, fatigue most days, and jaw spasms while on the 5FU pump and several days after. Many have nausea and can't eat. I'm guessing he'll also have the 24 hour pump. Ours was put on and taken off by a home health nurse at our home. It's like a little fanny pack that he wore on his belt and was able to drive, and get out and about. I think others do it differently,he got the pre-meds at the hospital first. Supposed to help with the nausea and fatigue.
So much to try to remember, but he finished his last, (11 txs.) in June of this year. The side effects are all gone now-except the one that counts-cancer is gone! That's the side effect we all want to have happen. I'm sure I've forgotten something and I'm also positive that others will be along to give other advice as well. Oh, stock up on anti-diarrhea meds and any prescriptions that dr. writes-fill. Just in case he has the need for them. Just be there for him. He'll need a sunshine person and you are it! Keep on watching this board and be involved cause it/we will offer you so much information.
Sandy0 -
Take a deep breath
Wow another Tina. Well, everyone reacts different so others will come on board so I will just tell you my husband's reactions. You can read about our cancer journey which began in March by clicking on our name. George is Stage IV with mets to liver and lungs and he has had a very good response to this chemo regimen. After 6 months our CT scan shows many of the mets disappeared and the rest showed significant reduction so we are staying the course. George had minimal to no nausea. His anti-nausea med was IV Anzamet. Fatigue, neuropathy in hands and feet, sensivity to cold (no cold drinks/ice and touching cold things), some metal taste were the primary side effects. George continued to work full time during his treatments but for the infusion days which he received every other week. His drugs were Anzamet, Decadron (steroid), the Oxi, 5FU and Avastin. Your husband will probably also receive a port in his upper chest for administration of the drugs. Google power port and you can see exactly what that is. If you have any specific drug questions just sign in and ask and someone will come on and give you their experience. Where was his cancer in his colon? Take a deep breath and welcome to the board but to be honest, I wish you did not have to be here. Tina G.0 -
thanks to both of you. hisgeotina said:Take a deep breath
Wow another Tina. Well, everyone reacts different so others will come on board so I will just tell you my husband's reactions. You can read about our cancer journey which began in March by clicking on our name. George is Stage IV with mets to liver and lungs and he has had a very good response to this chemo regimen. After 6 months our CT scan shows many of the mets disappeared and the rest showed significant reduction so we are staying the course. George had minimal to no nausea. His anti-nausea med was IV Anzamet. Fatigue, neuropathy in hands and feet, sensivity to cold (no cold drinks/ice and touching cold things), some metal taste were the primary side effects. George continued to work full time during his treatments but for the infusion days which he received every other week. His drugs were Anzamet, Decadron (steroid), the Oxi, 5FU and Avastin. Your husband will probably also receive a port in his upper chest for administration of the drugs. Google power port and you can see exactly what that is. If you have any specific drug questions just sign in and ask and someone will come on and give you their experience. Where was his cancer in his colon? Take a deep breath and welcome to the board but to be honest, I wish you did not have to be here. Tina G.
thanks to both of you. his cancer was it the part of the colon that attaches to the small intestine. I haven't learned all the correct terms yet. The colon had tore through and we're fighting infection now.0 -
Hi Tina
My husband was on Folfox + avastin. Oxy can be a beast for some. The cold thing is the biggest bummer. And it can make them feel pretty crappy. John did pretty good on it. He hated not being able to drink cold drinks in the summer and was very careful not to reach into the freezer. He had a real bad reaction on the seventh treatment and they did try it again on the eighth treatment and he reacted again. They took him off of it and he is on Xeldoda now with avastin every three weeks. It does do a number on the tumors so I would at least give it a try. If it is to much for him they can take it out of the mix or switch him to Folfri. Everyone seems to react different. Best to you and your husband. Paula0 -
manageable side effects
for the most part I agree with your doctor about side effects being manageable-
however, they do tend to get more pronounced or worse with each chemo treatment. My oncologist described it as being the body gets less tolerable and more toxic.
It is the oxil that is the rag-of-a-drug, and most of us don't make it to treatment number 12 without the oxil being cut back or omitted all together. The biggest issue is the neuropathy in the fingers and toes. I am 11 months out from chemo and looks like permanent damage in my fingers and toes from the oxil.
That being said
I was hospitalized 3 times for chemo issues- the first one was 2 weeks after first infusion- my blood counts hit the floor and ended up with a blood infection. The second and 3rd ones were due to mouth sores and dehydration. After the 3rd hospitalization, my oncologist cut the oxil completely- said I was DONE with oxil. I was pretty sick- very weak, dizzy and overall crummy for 6 weeks after the last of the oxil was given to me. I truly felt and looked like a cancer patient during that time.
I think probably the best thing you and your husband can do- ask one hundred million questions of the oncologist nurse about anything and everything from side effects to medication to help through them.
The best out of all of this is I am NED for 18 months. It was hard- but I am now facing forward and not looking back.0 -
Welcome
First of all I wanted to welcome you to the board and I'm sorry you had to find us, but you have come to a wonderful, caring group. You and your husband can ask any questions that you want as there is a lot of knowledge on this board.
I was on the oxi, leucovorin and 5FU. My tummy felt upset during infusion and about 3-4 days after disconnection, but never threw up. The Decodron (steroid) made me stay awake for 3 days. The oxi was hard on me but tolerable at most points. I got very fatigued so if he gets tired make sure he rests. Watch out for the cold things like the others have told you. Make sure he has gloves to go into the fridge with. If you live in cold weather states, make sure he wears a hat and scarf. The neuropathy can come on fast as mine did so be sure to tell the doctor if he starts feeling the numbness in hands and feet.
You both have a new family here and just wanted you to know that. Make sure you write down all the questions for the doctors as you won't remember them. Let us know how things are going.
Kim0 -
a good resource
for cancer drugs
http://www.chemocare.com/bio/oxaliplatin.asp
You can look up other drugs on that site too.
I won't get into my issues with oxy here because I am in the 1-2% category with the weird extreme reactions to this drug.0 -
Sorry Tina- quite a shock I
Sorry Tina- quite a shock I know. I am also new to this board. My husband was dx last week of July this year with stage IV rectal. He had a colostomy right away without surgery to get started with the systemic chemo asap. He has been on 5FU, oxaliplatin, and avastin (this was added 4 weeks after surgery). He had significant problems from the oxy right away. Almost as soon as the infusion started, he could not drink the room temp. water he had been drinking before. He describes the pain as like swallowing glass. He also suffered from terrible nausea around day 4 after infusion. Once they put him on emend that was significantly reduced. Oxy also gave him trouble with neuropathy immediately, and that can be a beast- even granite counter tops are too cold. It took 2 tough treatments before they started giving him infusions of calcium and magnesium- it made a huge difference! I would ask about that right away. The other problem that has been significant are the mout sores. The 'magic mouthwash' (a prescription) helps, but not completely. I would ask for a script for it right away though, just to have on hand.
My husband just had his 7th treatment last week. That was the first time that his bloodwork showed that his platelets were low. His onc. took him off the oxy this time to give his platelets a chance to rebound. The timing was nice, because we got a real snow here in mid-NC, which doesn't happen much, and he was able to play in the snow with our kids!
The biggest thing I would say is to tell the onc about all the symptoms! Do not let him be a tough guy. It is amazing what they can do for the side effects. Don't ever be afraid to call the onc on call- in the first few treatments I ran to the all night pharmacy many times getting various anti-nausea meds, the magic mouthwash, ativan...
And, at my husband's first scan after starting treatments he had a 10-20% reduction of the cancer in his body. So for all it is a beast, it has been a helpful one!
Hope all goes well and you get him home soon.
Kim0 -
Oxy and the 10 top things to look out for..........krf said:Sorry Tina- quite a shock I
Sorry Tina- quite a shock I know. I am also new to this board. My husband was dx last week of July this year with stage IV rectal. He had a colostomy right away without surgery to get started with the systemic chemo asap. He has been on 5FU, oxaliplatin, and avastin (this was added 4 weeks after surgery). He had significant problems from the oxy right away. Almost as soon as the infusion started, he could not drink the room temp. water he had been drinking before. He describes the pain as like swallowing glass. He also suffered from terrible nausea around day 4 after infusion. Once they put him on emend that was significantly reduced. Oxy also gave him trouble with neuropathy immediately, and that can be a beast- even granite counter tops are too cold. It took 2 tough treatments before they started giving him infusions of calcium and magnesium- it made a huge difference! I would ask about that right away. The other problem that has been significant are the mout sores. The 'magic mouthwash' (a prescription) helps, but not completely. I would ask for a script for it right away though, just to have on hand.
My husband just had his 7th treatment last week. That was the first time that his bloodwork showed that his platelets were low. His onc. took him off the oxy this time to give his platelets a chance to rebound. The timing was nice, because we got a real snow here in mid-NC, which doesn't happen much, and he was able to play in the snow with our kids!
The biggest thing I would say is to tell the onc about all the symptoms! Do not let him be a tough guy. It is amazing what they can do for the side effects. Don't ever be afraid to call the onc on call- in the first few treatments I ran to the all night pharmacy many times getting various anti-nausea meds, the magic mouthwash, ativan...
And, at my husband's first scan after starting treatments he had a 10-20% reduction of the cancer in his body. So for all it is a beast, it has been a helpful one!
Hope all goes well and you get him home soon.
Kim
(1) Cold Sensitivity....Im not talking about being cold im talking about touching something and it feels like your fingers are instantly freezing, or taking a drink of anything below room temperature and your throat feels as if its closing up with shards of glass sticking in it. It is an instant feeling just after chemo and will soon be constant until chemo is completed (probably every 2 weeks for 6 months total of 12)...anyway, it won't take but 1 time to understand what I am talking about...Cold air(winter air) will do the same thing. Your lips will start to go numb, speech will slur, its like being in a dentist office and the novacaine wearing off...but you'll get use to it....
(2) Jaw spasms...This will be anything you first take a bite out of will cause your jaws to act as if it just took a big bite out of a very sour lemon...Mine was very minor but still there, some are very painful...but you'll get use to it......
(3) Nausea...This was my worst part of the whole ordeal...I did Compazine, then Zofran, then Anzemet, then Emend...The Emend helped the most but I still was nauseous for 4-6 days. Believe it or not Chili was a staple for me at small doses. Everything will taste and be different. Somethings you love to eat you won't be able to smell. You will acquire a whole new diet...but you'll get use to it.......
(4) Neuropathy....Nerve Damage mostly to the fingertips and toes and bottom foot pads...caused by the Oxy, if continued for to long can be permanent, thus the need to keep the Onc and all Nurses up to date on how you feel at all times..This is the main reason most never finish the 12 treatments , me included, I finished 10 with oxy and then the last two with leucouvorin and 5fu. Its probably the most pronounced and longest lasting side effect of oxy....but you'll get use to it....
(5) Port...This will most likely be the way the chemo will be introduced into your circulatory system...It is a round disk usally either single or double about the size of a quarter that is placed under the skin either with a local (not advised) or as an outpatient (advised). It will generally be placed just below the collarbone and will raise the skin about 1/4". This will be where the nurse will access with the needle to start the pre meds and also the chemo infusion...some use Lidocaine to glob on the port about 1 hour before infusion and you won't feel the stick...Its not very much fun, but you'll get use to it.
(6) Blood Draws and CBC (combined blood counts), WBC (White Blood Counts) usually done on the off weeks to assure that your blood counts and your immunity system(WBC) are not being compromised by being killed off by the chemo and not regenerating by themselves. You may miss some treatments which will prolong the time it takes for the 6 month regimen to be over with but for the most part there are 2 different types of shots that can be taken and either one will get you back to normal counts so that treatments can be continued...if you don't like needles , neither did I..but you'll get use to it...
(7) Neupagen or Neulasta...These are the shots that we do in order to boost our immune systens if our counts get low (usually the White Blood Counts) (WBC). The Neulasta is a one shot deal given in the back of the arm or in the stomach, Neupagen is a 2-3 shot regimen either given in back of arm or stomach. These injections have side effects normally minimal being slight headache and slight lower back pain. Some people have harder side effects . It is handled better if it is held in the hand and warmed before it is injected and if it starts to sting have them slow down the injection. It reproduces white blood cells at a greater speed than the body does normally and the sacrum usually pays for it...Its kind of a pain in the butt, but you'll get use to it...
(8) Hydration...Probably at the top of the list for things that you need to make sure you do...Water at room temp is bad enough but relevant in flushing out the chemo in your system, making you regular in bathroom issues, preventing dehydration (which is very prevalent in oxy patients because of the inability to eat or drink due to nausea). Small sips very often will make you feel a lot better a lot faster. It rinses out the residual chemo that wants to stick around and make you smell and reek of the metal taste and smell you will notice...room temperature water is nasty at best, but you'll get use to it...
(9) Nurse from Hell...There will undoubtably be the one nurse that will get you riled up no matter how well mannered you are. This will be the one normally with the Black fingernails polished, spiked hair, and the ina godda divita (LMAO)Tee shirt on. In her earlier days she was a spoiled little rich girl and her daddy cut her out of his will after she managed to get through nursing school by a Master in beer and a Minor in bicycle seat sniffing...she will be the one that you will be given to first, don't worry, you will remember her, it will be the first one that touched you in Oncology, and the last time that she will touch you, for you will let her know that she will be off limits to your veins or anything else you physically own...You won't like having to get a restraining order against her, but you'll get use to it...
(10)...Last but not least, "The Last Treatment Day"...This is suppose to be the epitomy of it all, the Grand end of chemo treatments, done, finito, finished...You will kiss all of the good looking nurses that have help save your life and made your journey as pleasant as possible, have listened to your every story and on bended knee served and cottled and cradled your every need. Your 2nd family so to speak as you have come to learn each of their names and some have become personal friends. You will even make up with the "Nurse from Hell" because you feel like everyone is now your closest friend and you have the world at your fingertips. Life is Great and now you can get back to life as it use to be.....WRONG...You feel as if everyone has abandoned you because all the attention you were getting at the oncologists office and all the nurses that were tooth and nail at your every beck and call are now doing the same to the other patients that are in the same need now as your were then, they have let you go on with your life and life as you know it has just done a major 180*...You are now going to have to adjust to your new "Normal" as it is, and start to learn how to manage with what you have been blessed to have left...your life...and I guarantee ya everyday you will wear a smile.....and life may be a little different than it was.......but you'll get use to it.....
Love and Hope for you as a caregiver and for your Loved One as a patient, the best for you both.................Buzzard.......0 -
very good postBuzzard said:Oxy and the 10 top things to look out for..........
(1) Cold Sensitivity....Im not talking about being cold im talking about touching something and it feels like your fingers are instantly freezing, or taking a drink of anything below room temperature and your throat feels as if its closing up with shards of glass sticking in it. It is an instant feeling just after chemo and will soon be constant until chemo is completed (probably every 2 weeks for 6 months total of 12)...anyway, it won't take but 1 time to understand what I am talking about...Cold air(winter air) will do the same thing. Your lips will start to go numb, speech will slur, its like being in a dentist office and the novacaine wearing off...but you'll get use to it....
(2) Jaw spasms...This will be anything you first take a bite out of will cause your jaws to act as if it just took a big bite out of a very sour lemon...Mine was very minor but still there, some are very painful...but you'll get use to it......
(3) Nausea...This was my worst part of the whole ordeal...I did Compazine, then Zofran, then Anzemet, then Emend...The Emend helped the most but I still was nauseous for 4-6 days. Believe it or not Chili was a staple for me at small doses. Everything will taste and be different. Somethings you love to eat you won't be able to smell. You will acquire a whole new diet...but you'll get use to it.......
(4) Neuropathy....Nerve Damage mostly to the fingertips and toes and bottom foot pads...caused by the Oxy, if continued for to long can be permanent, thus the need to keep the Onc and all Nurses up to date on how you feel at all times..This is the main reason most never finish the 12 treatments , me included, I finished 10 with oxy and then the last two with leucouvorin and 5fu. Its probably the most pronounced and longest lasting side effect of oxy....but you'll get use to it....
(5) Port...This will most likely be the way the chemo will be introduced into your circulatory system...It is a round disk usally either single or double about the size of a quarter that is placed under the skin either with a local (not advised) or as an outpatient (advised). It will generally be placed just below the collarbone and will raise the skin about 1/4". This will be where the nurse will access with the needle to start the pre meds and also the chemo infusion...some use Lidocaine to glob on the port about 1 hour before infusion and you won't feel the stick...Its not very much fun, but you'll get use to it.
(6) Blood Draws and CBC (combined blood counts), WBC (White Blood Counts) usually done on the off weeks to assure that your blood counts and your immunity system(WBC) are not being compromised by being killed off by the chemo and not regenerating by themselves. You may miss some treatments which will prolong the time it takes for the 6 month regimen to be over with but for the most part there are 2 different types of shots that can be taken and either one will get you back to normal counts so that treatments can be continued...if you don't like needles , neither did I..but you'll get use to it...
(7) Neupagen or Neulasta...These are the shots that we do in order to boost our immune systens if our counts get low (usually the White Blood Counts) (WBC). The Neulasta is a one shot deal given in the back of the arm or in the stomach, Neupagen is a 2-3 shot regimen either given in back of arm or stomach. These injections have side effects normally minimal being slight headache and slight lower back pain. Some people have harder side effects . It is handled better if it is held in the hand and warmed before it is injected and if it starts to sting have them slow down the injection. It reproduces white blood cells at a greater speed than the body does normally and the sacrum usually pays for it...Its kind of a pain in the butt, but you'll get use to it...
(8) Hydration...Probably at the top of the list for things that you need to make sure you do...Water at room temp is bad enough but relevant in flushing out the chemo in your system, making you regular in bathroom issues, preventing dehydration (which is very prevalent in oxy patients because of the inability to eat or drink due to nausea). Small sips very often will make you feel a lot better a lot faster. It rinses out the residual chemo that wants to stick around and make you smell and reek of the metal taste and smell you will notice...room temperature water is nasty at best, but you'll get use to it...
(9) Nurse from Hell...There will undoubtably be the one nurse that will get you riled up no matter how well mannered you are. This will be the one normally with the Black fingernails polished, spiked hair, and the ina godda divita (LMAO)Tee shirt on. In her earlier days she was a spoiled little rich girl and her daddy cut her out of his will after she managed to get through nursing school by a Master in beer and a Minor in bicycle seat sniffing...she will be the one that you will be given to first, don't worry, you will remember her, it will be the first one that touched you in Oncology, and the last time that she will touch you, for you will let her know that she will be off limits to your veins or anything else you physically own...You won't like having to get a restraining order against her, but you'll get use to it...
(10)...Last but not least, "The Last Treatment Day"...This is suppose to be the epitomy of it all, the Grand end of chemo treatments, done, finito, finished...You will kiss all of the good looking nurses that have help save your life and made your journey as pleasant as possible, have listened to your every story and on bended knee served and cottled and cradled your every need. Your 2nd family so to speak as you have come to learn each of their names and some have become personal friends. You will even make up with the "Nurse from Hell" because you feel like everyone is now your closest friend and you have the world at your fingertips. Life is Great and now you can get back to life as it use to be.....WRONG...You feel as if everyone has abandoned you because all the attention you were getting at the oncologists office and all the nurses that were tooth and nail at your every beck and call are now doing the same to the other patients that are in the same need now as your were then, they have let you go on with your life and life as you know it has just done a major 180*...You are now going to have to adjust to your new "Normal" as it is, and start to learn how to manage with what you have been blessed to have left...your life...and I guarantee ya everyday you will wear a smile.....and life may be a little different than it was.......but you'll get use to it.....
Love and Hope for you as a caregiver and for your Loved One as a patient, the best for you both.................Buzzard.......
thanks
very good post
thanks 0 -
Welcome Tina
HI Tina, I just wanted to welcome you and hubby. Hope that infection clears up soon! OUCH
Hey, I'm going to guess that doc will add another med such as Avastin to that menu of drugs. FOLFOX, which is 5FU, oxi and a vitamin to help the 5FU remain active longer is used for Stage III and Stage II's.
I'm 59 (was dx'd Stage III) in a few days and completed 12 tx's of FOLFOX in August. Still have neuropathy but I can tell it's a bit better. All other side effects (bloody nose, jaw spasms, bleeding gums, etc) have cleared up.0 -
oxy
oxy was a beast for me. We got an excellent response. Liver tumors shrunk so I changed from inoperable to operable. The oxy got to be too much and my system just started rejecting it. I ended up being transported from clinic to hospital a couple of times. Now no more oxy for me.0 -
Oxy and room temp liquidszenmonk said:oxy
oxy was a beast for me. We got an excellent response. Liver tumors shrunk so I changed from inoperable to operable. The oxy got to be too much and my system just started rejecting it. I ended up being transported from clinic to hospital a couple of times. Now no more oxy for me.
Buzzard basically covered major issues with oxy but if your apartment or house is cold in winter, so is room temp. I just drank a room temp nutrition drink and my throat closed up where I had extreme difficulty breathing (also have COPD)and started to panic till I remembered to drink hot water when/if this happened but problem subsided by then. You don't want to do this to yourself.I'm currently on FOLFOX, which includes Oxy and I had Oxy(and Xeloda and radiation) prior to colostomy and now FOLFOX.Take it day by day (sometimes hour by hour-I've gone minute by minute at times)you can beat this, try to be strong, never give up and the people here-both fellow warriors and equally important, caregivers-, I have found, to be truly helpful and supportive and you need that too....Best of results in your treatment......Steve0 -
thank youcoloCan said:Oxy and room temp liquids
Buzzard basically covered major issues with oxy but if your apartment or house is cold in winter, so is room temp. I just drank a room temp nutrition drink and my throat closed up where I had extreme difficulty breathing (also have COPD)and started to panic till I remembered to drink hot water when/if this happened but problem subsided by then. You don't want to do this to yourself.I'm currently on FOLFOX, which includes Oxy and I had Oxy(and Xeloda and radiation) prior to colostomy and now FOLFOX.Take it day by day (sometimes hour by hour-I've gone minute by minute at times)you can beat this, try to be strong, never give up and the people here-both fellow warriors and equally important, caregivers-, I have found, to be truly helpful and supportive and you need that too....Best of results in your treatment......Steve
Thank you all so much!!! It means alot to hear from people who have been here. I'm real sure I'll be back with more questions. Good Luck to you all
Tina0 -
Keep asking Tinalostit2003 said:thank you
Thank you all so much!!! It means alot to hear from people who have been here. I'm real sure I'll be back with more questions. Good Luck to you all
Tina
Its scary enough as it is and you'll find plenty of help here as I did and it makes a world of difference knowing there are others who've been ahead of you and will share their experiences, knowledge, etc making your journey a little more manageable. Believe me, this helps alot,even if only to vent...steve0 -
Tina,lostit2003 said:thank you
Thank you all so much!!! It means alot to hear from people who have been here. I'm real sure I'll be back with more questions. Good Luck to you all
Tina
I did the 5FU for 9 treatments after a round of xeloda and radiation. I tolerated it quite well, the only side effect I have suffered from is the neuorapathy in my hands and feet. Everyone reacts diffrently. Be strong and you will get through this!
Kathy0 -
usually if you come in afterkhl8 said:Tina,
I did the 5FU for 9 treatments after a round of xeloda and radiation. I tolerated it quite well, the only side effect I have suffered from is the neuorapathy in my hands and feet. Everyone reacts diffrently. Be strong and you will get through this!
Kathy
usually if you come in after Buzzard,
there is nothing left to say,
but good luck and God bless
oh> when i needed to touch cold things (cooking)
i used to wear cotton gloves covered by surgical gloves.
and when the pains in your fingers get bad ,
run them under warm water.
DO NOT EAT ICE CREAM !!!!
Sometimes room temperature things can be painful.
make things warm.
bundle up when you go out,I mean,ONLY EYES EXPOSED.
kATE0 -
Keep warm gloves handy
HI Tina,
I am currently on the folfox treatment. I do not get the bolster shot in the middle day but I do have it with Avastin. Ask your onc about Avastin with stage IV. As for side effects, I do get the cold in my hands and mouth, no sores yet but I'm lucky, I do get very nausea so I take Amend with all the other regular drugs and it takes me about 4 days to get somewhat back to normal. However, this is the second time I've been on this regimen. The first time I was on it I wasn't nausea at all or had bowel problems. I did have an iliostomy and that helped. This time I do have bowel problems but I'm working with it. Hang in there and just stay warm.
Jill0
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