Ever since I was a child, I have been a champion at projectile vomiting. When I say champion, I mean gold medal-winning, spectacular, awe-inspiring, etc. My parents shared these stories with a variety of friends and new boyfriends (in addition to the cringe-worthy photo albums) over the years and I've become a lot less embarrassed about it, well, sort of. After all of the vomiting incidents when I was a child, I've worked pretty hard to be able to control my urge to vomit, even handled two pregnancies when I was nauseous 24/7 without vomiting more than once or twice and always in the comfort of my home.
Chemotherapy for stage 4 breast cancer
And then I was diagnosed with stage IV metastatic breast cancer (MBC) and I started chemo.
The chemo-induced nausea was an entirely different animal and I did spend a day or so bowing before the porcelain throne after each infusion of the red devil. Once that day or so had passed, I was able to avoid the nausea and after I was able to sign up for a medical marijuana card here in Florida, it wasn't much of an issue any longer, or at least I had tools that helped.
In 2019, I had progression on my first line of treatment, Ibrance, and Letrozole, and I started Piqray. Then, a few months into 2020, when Piqray appeared not to be working as it should, we added Kisquali. Both Piqray and Kisquali have nausea and vomiting as known side effects.
And if a drug has nausea as a known side effect, I get it. Combine more than one medication with a side effect of nausea and that's not a great recipe for avoiding the bathroom. And yes, I still have projectile vomiting, so much so that my husband has had to spend a great deal of time cleaning up after me, not a great marital moment.
After a great deal of trial and error, I've found a few things that help (disclaimer: I'm not a doctor or any kind of medical professional, just a patient who has had to figure some things out; always check with your medical team if you are planning to add any remedies, including over the counter, to ensure that there are no issues or contraindications):
During chemo, I discovered that I'm allergic to Zofran. As if I needed another complication! My doctor prescribed Kytril (Granisitron) as an alternative and that has helped, to a point. The issue, for me, with Kytril is that I can only take it every 12 hours. Sometimes I need a little more help throughout the day.
Prescription medication #2
My palliative care doctor recently prescribed Reglan (metoclopramide) to help between doses of Kytril. Added benefits - it helps with headaches and it literally slows down some aspects of digestion, which has helped with other GI issues.
I use ginger in many forms. Ginger tea, ginger chews, etc. Ginger can have a strong spicy taste, so I've learned to moderate my use, but it does help.
I use peppermint in a variety of forms, tea, essential oils, etc. It's effective and it smells good too!
It's a bit counterintuitive, but I'm often nauseous when I don't have anything in my stomach. Eating small, frequent meals or grazing has helped me manage my nausea better.
I recently stumbled upon this on Amazon. It's a stick that contains a variety of essential oils that you keep with you and smell when needed.
Again, it's weird, but when nausea is strong, tearing open an alcohol pledget and smelling it does help. This remedy was a suggestion by a chemo nurse and it works! I've taken to carrying a few in my purse just in case.
Timing of taking medication
I've usually taken my medication in the morning, but when we added Kisquali, I realized that taking everything together might be more toxic for my body than I'd realized, so now I take Piqray in the morning and Kisquali at night. This means I can take Kytril with Piqray in the morning and another Kytril in the evening with Kisquali. That's made a big difference for me.
Sometimes a prescribed medication comes with instructions about eating or not while taking it. Sometimes they don't. I've found that with most of my medication, taking them on an empty stomach is not a good idea. So I try to have eaten a little before I take the medication.
Avoiding certain smells/foods
It's weird, I know, but ever since I was pregnant, certain foods and the smells of foods make me nauseous. Fried chicken and bananas are my kryptonite.
Now it's your turn -- what are your favorite remedies for nausea?
How well do your friends and family understand your diagnosis?