Also see
First Rituxan Day - Checklist |
When
to Call your Doctor |
Treatment
Support
Tips For Coping With CHOP-R, CVP-R,
or Bendamustine-R
- From Patient
Experience
Thanks to the WebMagic support
board on an excellent thread.
We thank all
for sharing their experiences.
TOPICS
Infusion Day |
Nausea |
Dealing
With Constipation And Gas
Hydration / Electrolyte Balance
| Prednisone |
Mouth
Sores
| Muscle Cramping
Sleep
| Fatigue |
Hair Loss
| Infection |
Diarrhea
| Other
Also see Understanding Drug Therapy and Managing Side Effects
leukemia-lymphoma.org
pdf
Getting through CHOP-R is not a picnic, but generally not as bad as we are led
to believe from the movies. For most patients, the anti-nausea drugs control symptoms well and
some patients are able to work. For some, but not all, symptoms worsen as treatment progresses.
The following are tips that different patients have suggested:
1) For the Infusion
a) Having a friend along for support and to
drive you home if you are too tired from the Benydryl can be
helpful.
b) Bring things to keep you occupied: Ipod, puzzles, laptop, books
etc.
Be sure to clean the keyboard, which can be a source of bacteria.
c) Wear comfortable, loose clothing. Bring a blanket, pillow
and/or slippers if you like.
d) Bring snacks.
e) Sucking on a popsicle or ice chips during the Cytoxan infusion
can be helpful.
f) If you have one, bring along your mediport information card.
g) Lidocaine and sticky pads can help to numb skin over a port.
i) See for about PICC
lines
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2) Things To Prevent Or Help Nausea
a) Ask your doctor to provide a prescription several days prior to the first chemo treatment.
Prior approval may be required by your insurance company. Delays - and unnecessary suffering - can be avoided with sufficient advance notice.
b) Good anti-nausea meds; Take what is
prescribed consistently and proactively for at least 3 days. (eg.
Kytril, Zofran, Ansamet Compazine etc). If what is initially
prescribed isn't working for you, discuss alternatives with your
doc.
c) Ginger can be helpful: 1) slice or crush about a half inch of
fresh ginger in a mug and steep this in hot water like tea.
2) Might try ginger root capsules.
d) Eating small snacks throughout the day can be helpful.
Some found a handful of Cheerios helped.
e) One person found that the smell of a freshly
cut tart apple helped quell her nausea.
f) Avoiding fried and fatty foods may be helpful.
g) Avoid odors that offend you.
h) Breath through your mouth when feeling nauseous.
i)
Food Tips for Managing Nausea and Maintaining Oral Health
When
to Call your Doctor
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3) Dealing With Constipation And Gas
a) Senakot-S (a gentle laxative with a stool
softener) and/or Colace (stool softener).
Take these regularly for roughly ten days if your oncology team is
OK with this.
b) Eat foods high in fiber. Prunes or prune juice can
be helpful.
c) Drink lots of fluids.
d) Some have found charcoal capsules for helping with flatulence.
e) Do not let constipation get out of hand. If
what you are doing isn't working speak with your doctor or nurse.
Constipation can easily get out of control if not dealt with
early.
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4) Stay Hydrated And Maintain Proper Electrolyte
Balance
a) Drink adequate fluids.
b) A mixture of half Gatorade and half water can be helpful.
c) Drink plenty of fluids before needle sticks.
It plumps up the veins and makes a successful stick easier.
5) Heart-burn
a) Over the counter or prescribed medicines can help with this. (eg.
Prevacid, Pepsid-ac, Zantac)
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6) Prednisone (CHOP or CVP)
a) To avoid its bad taste: 1) ask the druggist for gel caps to put
the prednisone in. 2) Take it with milk or chocolate milk or take it with
food; can wrap it in bread or take it with pudding.
b) If you have an emotional crash when you stop,
your oncologist might be willing to taper the dose more slowly if
you ask.
c) Many people need a prescription sleep aide to
achieve a good nights sleep when taking Prednisone.
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7) Preventing And Dealing With Mouth Sores
a) Rinse mouth frequently
1) 8 oz warm water and a half teaspoon of
salt; or
2) Rinse with a mixture of a teaspoon of baking soda and 8
oz water; or
3) Get a prescription for magic mouthwash.
4) Diphenhydramine & Kaopectate (dentist
RX for mouth sores)
b) Ice pops or frozen Jello can be soothing.
c) Watch the temperature of your food. Your mouth may burn
more easily.
d) Brush your teeth after every meal and snack.
If brushing is too painful because of mouth sores a baby
toothbrush may help or just a fingertip with a bit of toothpaste.
When
to Call your Doctor
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8) Muscle Cramping
a) The following foods/drinks might help: tonic
water with quinine, Gatorade, and/or bananas. Red potatoes also are high in potassium.
b) If your doctor puts you on a potassium supplement and you have
a hard time swallowing the pills, it also comes in a tasteless
powder form you can mix with food or drink.
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9) Sleep Disturbance
a) Prescribed medicines can help. Talk
with your doctor and see if he/she thinks there is one that might
help you. Examples of prescribed meds that people here have
found helpful:
Ambien, Lunesta, Ativan, Xanax and others.
b) Low dose Trazedone helps some with sleep and since its in a
different class then the medications listed above it is less
addicting.
c) Sleep disturbance, especially early morning awakening, can be a
symptom of depression. If you are depressed, go over your symptoms
with a doctor to see if he/she feels an antidepressant might help
you.
d) Google "sleep hygiene" for tips on behavioral
strategies for coping with insomnia
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10) Dealing With Fatigue
a) Maintaining a gentle exercise program such as
walking can help reduce fatigue and make it easier for you to
sleep at night.
b) Take a nap if you need it.
c) Ask others for help when you need it.
d) If you are depressed, discuss this with your doctor. Medications can treat depression.
e) Identify what's most important to do, and use your energy for these tasks.
f) Try to include shorter versions of activities you enjoy.
g) If you are able, take short walks or light physical activities to help combat fatigue.
h) Try activities such as prayer, meditation, yoga, guided imagery, visualization, etc.
i) Try eating smaller portions of food and avoid foods that may make you sluggish.
j) Limit your use of caffeine, alcohol and foods that are high in sugar or difficult to digest.
k) Maintain a diary of how you feel each day.
l) Moderate exercise! Within your limits. Studies
seem to support keeping active.
Also see Fatigue
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11) Hair Loss (not Bendamustine)
a) It will generally fall out around the time of
the second cycle. Shave it ahead of time as its
messy and disconcerting watching huge clumps of hair fall out. It
is empowering to some people when they shave their head and
"take control" over that one thing.
b) If you plan to wear a wig, get it ahead of time so they can match your natural color if
that's want you want.
c) Be a blonde one day, red head the next. Go wild with scarves
and find your inner gypsy!!
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12) Reduce Risk Of Infection
a) Wash your hands often, especially after being
in public places, around others with colds etc. Keep nails short.
It's harder to keep nails clean that are long.
b) Avoid crowds when your counts are low.
c) Follow guidelines given by your treatment center.
d) Clean equipment and tools you will use
frequently, such as keyboards, cutting boards ... air
dry.
e) When you can't wash your hands, have a hand
sanitizer with you.
Also see Avoiding Infection
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13) Diarrhea
Uncontrolled diarrhea can lead to
fluid depletion, electrolyte imbalance, skin damage, and even death
if it persists too long.
a) Diet can help: One person found that oatmeal, cantaloupe, tomatoes and some raw foods helped her. Others have found that binding foods, like rice and bread help
b) If it's extreme prescription Tylenol 3 helped one patient as it is constipating, the OTC Imodium A.D. liquid also helped the same person.
c) One person recommended prescription Questeran
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14) Other
a) Discuss your risk of Deep Vein Thrombosis (DVT)
(a clotting condition) with your doctor. An aspirin a day may
reduce this risk. One or two of us have had problems with this
that might have been avoided.
b) If you experience any unusual symptoms or fever, call your doctor or oncology
nurse. Do not feel you have to wait until office hours if
you are really uncomfortable or anxious about something.
Food Tips for Managing Nausea and Maintaining Oral Health
