What Happens When You Miss A Treatment?

Hello All,

I thought I would update what was going on with my daddy and once again ask another question. What happens when you miss a chemo treatment?

I mentioned his extreme nausea after his 1st chemo treatment in an earlier post. My mom had told me how bad it was but until I got to their house, I did not understand. I went the night before he was to go for chemo so that my mom could rest and take a bath. Daddy had been so sick that she had not been able to even shower. Anyway, it was unbelievable. He would  throw up and throw up and throw up, throw his head back and gasp for air, and it would start again. He got about 1 1/2 hrs sleep in the recliner and I slept on the couch. I woke up to him vomiting again.

Needlessly to say, when we got the drs. office for his next treatment he was too weak to receive it. Our doctor has is very knowledgeable and has been great but when momma was trying to describe how sick daddy had been I got the feeling that she was thinking 'it couldn't be that bad." He spent the day in "clinic" (where the administer chemo) receiving iv fluids and zofran because there was no room available on the oncology floor. It turned out to be a good thing, though. The chemo nurses got a good dose of how bad his nausea was and called the drs. office to report on how sick he was several times that day. I hated for him to be sick but this at least validated what had been described to the doctors.

He has been in the hospital since Thursday. They started him on reglan Thursday night and this helped the nausea tremendously. They gave him a patch that helps to cut down on the production of secretions-starts with an s-the name escapes me. They also gave him ativan. This worked well the previous hospital stay but they sent him home on zanax instead of ativan. Maybe because his PC dr. had prescribed it when all this started(???) Things went well the first night and the 2nd night he had diarrhea throughout the night. They have taken stool samples every 24 hours since that time (the diarrhea has slowed to a loose stool occurring maybe 2x per day). They took him off the reglan today. He has not been nauseated and I understand that reglan promotes digestion and could possibly be part of the diarrhea culprit. They want to get another sample tonight at 11:00 pm. I don't know what they'll do if he doesn't produce a sample at this time :>)

They have also cut back on the ativan and daddy has become a little aggitated. Not sure if this is a side effect but I really don't know why they don't leave him on it. It helps the pain, nausea, and anxiety that he has. I know it comes in a oral form and could be put in the feeding tube. He has been on a few short walks since he's been there and has been sitting in a chair a lot instead of lying in bed. The drs. say he may go home tomorrow.

Anyway, back to my original question. What happens when you miss a treatment? He missed Thurs. so I assume he will start back this coming Thurs. Does it have any impact? If so, then what?

Thanks!

They prefer to follow the protocol because that's how they use it in trials and determine how useful various treatments are.  They will not use chemo if they think they might kill the patient with it.  Hydration generally makes a huge difference in the patients' state.  Once they are that sick, they frequently need hydration either "in clinic" which I prefer because I could take him home again or "in hospital" which is needed when it gets really bad because it can also affect other organs such as the heart, etc.  Sometimes I preferred "in hospital" just because I was so exhausted from weeks of caretaking, and it would give me an opportunity to sleep uninterrupted for a night or two.  His oncologist would always recommend I take as much of the time to rest as possible.  The flip side of hospital is risk of infection is much higher, which can be fatal.  We postponed week 4 of 6 consecutive weeks of chemo, so it took us 7 weeks to do his first round which was pre-surgical..  We also pushed up our radiation on a day when he was sick all night and too weak for me to take.  I think that was also the first time I had to have him hydrated.  We need fluid to function and when you have excessive vomiting or diarrhea you have to replace it before you will start to feel better.  In spite of having to move treatment up, we had successful round of chemo and radiation and were able to do surgery following the first round.  Sorry it's so rough.  My husband was just as sick as your Dad and there were moments I felt like I was going to lose it with how bad things were.  I know how hard it is to get through.  Your Mom must be beside herself.  I will keep you all in my prayers.  In time the oncology staff will get to know you and realize when you say it's bad that it really is.  Many people do not have such violent reactions to chemo, (in fact I saw very few people as sick as Pat was from chemo) so they don't anticipate it being that bad.  I've never seen another person cleaning up vomit on the infusion room floor, or even seen another patient sitting with a bucket to puke in, which was a regular occurence for us.  I kept a pail in the car because we had days we couldn't make it 5 minutes to get home without throwing up.  It's been about 2 years since those awful days (the pail is still in my trunk), and we are still here and have many good days which we are very thankful for.  Hope today is a better day for all of you.     

I had to almost laugh when you mentioned the mopping of the floor and the pail in lap. Although they did not have to mop up after daddy he did have his pail in his lap constantly. No one else there did and daddy felt so bad that he was "disturbing" everyone around him. We were fortunate to meet a man that was sitting directly across from him who was there for his first treatment for EC. It did daddy so much good to talk with another person in a similar situation! I did tell the man, more than once, that daddy's response to chemo was not the norm. I was so afraid that watching daddy was going to terrify him about what was to come!

My mom truly is beside herself. I am two hours away and my sister and brothers are an hour away from their house. We're all two hours from MUSC, including my parents. We are all trying to help out and spend the night at the hospital, etc. so that she can get some rest. But in the end, she is the one who is the 24/7 caregiver.

Thanks for all the advice and kind words. I pass all the information I get here on to Daddy and it helps to know that others have experienced some of the same things.

Is this the week you go back to school? I am sure you're excited. Teaching is my 2nd career and I am still learning-just finished my masters in Dec-just before Daddy's diagnosis. How's that for timing?

Believe it or not, you get so you laugh over some of the horrors at some point.  We joked about the feeding pump noise after awhile, as well as other things.  If you didn't laugh at how absurd it can get, you might go crazy.  School starts tomorrow, and we are waiting on CT from last week.  I thought when I finished at break in December that we were in the clear till June before the next CT, so things can change quickly but I still think he's recuperating from surgery and the cancer isn't going to crop up now.  I keep tapping my tongren doll daily.  If I were thinking about top EC places I would consider Pittsburgh (University of Penn Medical Center?)-MD Anderson in Texas-Dana Farber in Boston (probably first since it's within an hour, although we started in our local hospital and have an excellent oncologist closer than Boston)-Sloan Kettering in New York.  I'm saying this from reserach along the way, but I bet you could search internet to come up with top rated Dr's or hospitals for EC.  Pittsburgh was cutting edge early on, and I think they've maintained that, and in our case is within an hour and a half of my husbands family who have lived at a distance through 24 years of our marriage.  Dana Farber is in the top 5 cancer centers in the country.  MD Anderson always interests me because they have programs integrating more natural forms of healing with traditional treatment to help with some of the side effects, and they have excellent EC care.  I would guess there will be some other suggestions from people who have experience at various centers and who know what they offer and how the care is.  I'll be interested to see what suggestions come.