Ginger for nausea

johnlax38 said:

Hi Deb,
A friend of mine who
Hi Deb,

A friend of mine who had chest cancer recommended the same to me, take ginger supplement tabs/pills before treatments. She claimed it helped her but I mentioned this to my doctors and nurses and they advised me to stay away from herbal and vitamin supplements as they may interfere with treatment drugs, etc... I'd say talk to your doctors and see what they say and make you decision from there. It's just ginger so I don't see the harm in them! I take them now post treatment and it helps with indigestion.

Hope all goes well.

Skiffin16 said:

EMEND
Not sure of his regime...

On mine during the nine weeks (three week cycles) of Cisplatin, Taxotere and 5FU, I took EMEND. One the day of chemo, then two each following day, never got sick once.

During the seven weekly doses of Carboplatin, I had Zofran just incase as needed. I rarely had problems with nausea though.

Best,
John

DrMary said:

Nausea Meds
The gold standard for preventing chemo nausea is Emend (you take 1 the morning of chemo and 1 each day for 2 days after) plus decadron (dexomethasone) for the first 5-8 days. Zofran (ondansetron) and decadron are often used together as well - a typical course for someone with your husband's nausea problems would be all 3 for the first 3 days and then zofran and decadron for another 2-5 days. (Insurance companies don't like to pay for Emend, as it is still very expensive).

All of these are preventive - only the decadron will help nausea after it's already started, and it takes a few days to do that (it does other things, such as help prevent swelling and stimulating appetite, especially when taken for weeks).

Ask about immediate-relief drugs if he has nausea despite the drugs (often happens day 5-8) - Compazine helps a lot, Ativan is good but makes you woozy. Decadron often causes hiccups, especially in men. Doug had them the first time, and they were bad; so we skipped the decadron the next time - not worth it, as his nausea was uncontrollable. Thorazine, in place of Compazine, will help with hiccups as well as nausea, and they apparently fade after 2 days anyway.

So, whatever, preventive antinausea drugs they prescribe, make sure you take them on schedule (don't skip because you feel better, or take them 2 hours later than you should because it's more convenient). If they give you back-up drugs, like Compazine or Ativan, take them as soon as you get nausea symptoms; if the nausea returns less than 4 hours later, you might need to consider switching drugs. If taking the drugs every 6 hours keeps it under control, then stick to that schedule at least until 8 days after chemo.

The back-up drugs, like compazine and ativan cause constipation. Really. Take your colace and miralax regularly and drink as much water as you can keep down or you will find yourself doing some rather nasty procedures. Really.

A caution about ginger - it works by speeding up gastric emptying (moving stuff from your stomach to your small intestine); some antinausea drugs work by trying to calm down your stomach muscles (thereby slowing stuff moving around) so doctors worry about them conflicting. I would avoid capsules and only consume whatever ginger my taste buds allowed - if they start saying "no" it might mean you are taking too much. There's a ginger gum marketed for motion sickness - I tried it and found it spicy, but effective. Doug's mouth was too sore at that point. My opinion is that it won't be effective for really bad nausea, however.

Consider printing this out and taking it to your doctor for discussion - I am not a medical doctor (I'm a chemist) but I picked up a fair amount of experience with these drugs (don't we all). My brother-in-law the doctor reminds me that this part of medicine is an art, and several approaches can work, so you might end up with a different mixture of drugs, but it's a starting point for the conversation. There are other drugs possible (Doug had to use one) that are saved for uncontrollable nausea (they have worse potential side effects, but most are rare) so don't give up if nothing is working. It took us many tries to get the best combo for Doug.

DrMary said:

Double Duty
Yes, a lot of anti-anxiety drugs are also anti-nausea (and vice versa - one reason airlines used to be happy to hand out dramamine for air sickness was it also put them to sleep) so Ativan can be used for both. Try to get extra of that - you can take one yourself if it all starts to get to you (although beer works almost as well and you can regulate the dosage better). Or (I'm sure his doctor would prefer) talk to your own doctor - I really underestimated the strain a caregiver goes through and wish I had done so.

I think they gave Doug both Zofran and Decadron in the IV during the infusion and then he continued them orally.

Another powerful anti-nausea drug (for after nausea shows up) you might ask to have handy is Phenargan - you can get it as a suppository, which is useful when someone is barfing various other guts up. It helped us turn the tide one night when Doug was really hurting. (It helps to have gloves handy when doing this - trust me.)

Zofran really is preventive, so you must take it regularly. Doug had sufficient problem with nausea from the pain pills that he finally had to stop taking them, but if the Zofran helps hold that off, great. (Again, the pain pills also cause constipation - I can't stress enough the bad situation you can get in if you let it go more than 2 days or so. Our doctor told us about a guy who went several weeks - they had to hospitalize him to take care of the impaction safely.)

We also found an interesting use for "Magic Mouthwash" - a mix of lidocaine, benedryl and antacid. Usually, folks use this to numb mouth and throat sores before eating. Our doctors didn't really like it, but I talked them into a script when he was throwing up so much. A shot of that right after throwing up helped with the incredible pain in his throat (both from the coughing and from the stomach acid on raw flesh) and also seemed to stop the aftershocks. For some, the worst part of nausea is indeed the pain of throwing up - with that at hand, Doug was willing to keep drinking water and supplements, knowing that if he did vomit, we could make it stop hurting fast.

Know that the day will come when you will not be a walking pharmacy and he will be only taking a few pills, if any. At one point, I think I had 8 pill bottles, 2 bottles of syrup, and 2 syringes on me at all times (plus a few suppositories) - his regular meds and the emergency back-ups. What a difference a month makes!