The Nightmare People Want to Keep You from Puking, Also Your Fingers
August 6, 2013 11:55 AM Subscribe
I am now in a round of chemotherapy for cancer, and I have been prescribed some really heavy duty medication for nausea. I can't take compazine because I am allergic to it. My prescription cocktail includes Emend, zofram, and marinol. Throw in some anti-coagulants, anti-depressants, and stomach acid calmer-downers, just for funsies.
So, this past weekend on chemo, things were fine-ish nausea wise, but I had a series of nightmares that were so vivid and scary that I'm still feeling scared two days later. I need help articulating a question for my doctors that will help me to keep my stomach calm, while leveling my head as well.
I should articulate that I am very well doctored, with a social worker, a counselor, an oncological psychiatrist, and a medical oncologist.
I should also state that I do think that it is the marinol that puts me over the edge. I have always hated pot, because it makes me a nervous wreck who locks herself into darkened rooms and worries. But the nightmares that I had this weekend were beyond anything I have ever experienced, involving brutal self-harm and terror.
That said, the idea of being as nauseated as I was before I was prescribed marinol is almost as scary as the nightmares.
Add to this the fact that anti-anxiety meds will make me sleep too much. Sleeping too much gets me dehydrated, which worsens the nausea.
Is the fear I experience when I am asleep the cost of the relief that I feel when I am awake?
Can someone out there on the green help me to articulate a way to approach this problem with my doctors, so that my delicate anti-nausea regimen is not too disturbed, while at the same time relieving my nights? If I add xanax to this regimen, will I end up a cracked-out mess?
I should articulate that I am very well doctored, with a social worker, a counselor, an oncological psychiatrist, and a medical oncologist.
I should also state that I do think that it is the marinol that puts me over the edge. I have always hated pot, because it makes me a nervous wreck who locks herself into darkened rooms and worries. But the nightmares that I had this weekend were beyond anything I have ever experienced, involving brutal self-harm and terror.
That said, the idea of being as nauseated as I was before I was prescribed marinol is almost as scary as the nightmares.
Add to this the fact that anti-anxiety meds will make me sleep too much. Sleeping too much gets me dehydrated, which worsens the nausea.
Is the fear I experience when I am asleep the cost of the relief that I feel when I am awake?
Can someone out there on the green help me to articulate a way to approach this problem with my doctors, so that my delicate anti-nausea regimen is not too disturbed, while at the same time relieving my nights? If I add xanax to this regimen, will I end up a cracked-out mess?
I would discuss with doctors and explain that you are having vivid-night-terrors. If you believe it's the marinol, say so. There may be other options.
They want you to be comfortable and they want to get it right.
posted by Ruthless Bunny at 12:15 PM on August 6, 2013
They want you to be comfortable and they want to get it right.
posted by Ruthless Bunny at 12:15 PM on August 6, 2013
I'm really sorry for what you're going through. I would just be as honest with your doctors as you can. Print this out even and bring it to them.
My only suggestion is re: the Xanax. Xanax is really great for things like panic attacks, acute type anxiety situations. If I were you I might consider something like Klonopin - same class of drug (benzo), but it's sort of mellower and lasts longer (8-12 hours). The Klonopin will definitely help with the nightmares - but it will make you probably want to sleep longer.
posted by Lutoslawski at 12:16 PM on August 6, 2013
My only suggestion is re: the Xanax. Xanax is really great for things like panic attacks, acute type anxiety situations. If I were you I might consider something like Klonopin - same class of drug (benzo), but it's sort of mellower and lasts longer (8-12 hours). The Klonopin will definitely help with the nightmares - but it will make you probably want to sleep longer.
posted by Lutoslawski at 12:16 PM on August 6, 2013
I'm so sorry you're going through this.
Speaking to your question: it's not entirely clear what you want to articulate to your doctors, but here are my suggestions:
Again, I'm so sorry you're going through this.
posted by scrump at 12:21 PM on August 6, 2013
Speaking to your question: it's not entirely clear what you want to articulate to your doctors, but here are my suggestions:
- Obviously, you should talk to your psychiatrist about this.
- It may be helpful to sit down and lay out the sequence of events as you experienced them, just so you know for sure you have them in order.
- It also may be helpful to write down your end goals: to me, it sounds like you want to get as much nausea relief as possible without affecting your ability to rest or sleep.
- If you have good doctors, it's okay to be scared and confused. Sometimes, especially when dealing with chronic illness, we have a tendency to put on a degree of false equanimity. It's okay to lose your shit sometimes.
I know we're dealing with a ton of meds here, but I feel like something's not working. The new nausea meds seem to have given me really vivid nightmares that are interfering with my sleep. I know I don't want to go back to the nausea, but I also know that anti-anxiety meds like Xanax make me sleep too much, and I wind up dehydrated. Can we discuss some other options?Right now, you're overwhelmed; try to decompress your head first (with your psychiatrist, or even by just taking some time for yourself), and then get in to see your primary doctor and just be frank and open with them.
Again, I'm so sorry you're going through this.
posted by scrump at 12:21 PM on August 6, 2013
I am not nor have I been on chemo. I am a redhead who gets freaky reactions to drugs, and have found that antibiotics that cross the blood brain barrier do all kinds of fun things that range from feeling drunk/high (cefa-something) all the way to night terrors so bad that the phrase REALLY doesn't do them justice (doxycycline). As in, if the choices were death or doxycycline, I'll take death thank you... and I'm serious.
It sounds like you had similar nightmares, so I would tell your docs about the nightmares but express how severe they were (people who haven't experienced it don't get it otherwise). Looking at what is new, and what crosses the blood brain barrier might tell what is the problem.
Critically, what you dreamt of does not say anything about you. At least two of those drugs do cross the barrier, much like doxy. Call your docs and let them know you're having a serious reaction. Thoughts of harming yourself count, even if they are drug induced and only in dreams.
posted by jwells at 1:01 PM on August 6, 2013
It sounds like you had similar nightmares, so I would tell your docs about the nightmares but express how severe they were (people who haven't experienced it don't get it otherwise). Looking at what is new, and what crosses the blood brain barrier might tell what is the problem.
Critically, what you dreamt of does not say anything about you. At least two of those drugs do cross the barrier, much like doxy. Call your docs and let them know you're having a serious reaction. Thoughts of harming yourself count, even if they are drug induced and only in dreams.
posted by jwells at 1:01 PM on August 6, 2013
I should also state that I do think that it is the marinol that puts me over the edge. I have always hated pot, because it makes me a nervous wreck who locks herself into darkened rooms and worries.
From what I have read, Marinol is high (heh) in THC and low in CBDs, which are other cannabinoids that are not so much with the psychoactive properties and more with the anti-inflammatory/anti-nausea properties. If Marinol comes in low-THC, high-CBD variations, you might give that a shot. I don't think it does, though.
Do talk to your docs about this, because you shouldn't have to suffer such crappy side effects even in your sleep!
posted by rtha at 1:43 PM on August 6, 2013
From what I have read, Marinol is high (heh) in THC and low in CBDs, which are other cannabinoids that are not so much with the psychoactive properties and more with the anti-inflammatory/anti-nausea properties. If Marinol comes in low-THC, high-CBD variations, you might give that a shot. I don't think it does, though.
Do talk to your docs about this, because you shouldn't have to suffer such crappy side effects even in your sleep!
posted by rtha at 1:43 PM on August 6, 2013
I'll just add that my mom, a retired and very experienced hospice nurse who is typically not a proponent of alternative medicine, highly recommends acupuncture for coping with nausea. Not sure if you've tried it, but thought I'd throw it out there.
posted by purenitrous at 7:50 PM on August 6, 2013
posted by purenitrous at 7:50 PM on August 6, 2013
My partner and I went through this last year. She was on two anti-nauseants, one was a 24 hour anti-nauseant and the other was "every four hours as needed. (The Zofran/Ondansetron if I recall correctly). The Ondansetron was giving her extreme anxiety and keeping her from sleeping. She spoke to her doctor, and stopped taking that one with relatively little impact. Slightly heightened nausea, but nothing major. They also prescribed mild anti-anxiety meds. Ativan I believe. She didn't take them very much, just knowing they were there if needed seemed to help calm her. She DID start taking sleeping pills to get her through the nights.
What's the solution? I don't know. In her case, less was more. Work it out with your doctors, tinker (with their cooperation), and find a balance that works for you. Everyone is on different drug cocktails, and everyone's body is different. There won't be a definitive answer here, or anywhere. Trust yourself, work with your doctors. You'll get through this.
...chemo is not very much fun, but they should be able to help you make it tolerable at least.
posted by Stagger Lee at 7:57 AM on August 7, 2013
What's the solution? I don't know. In her case, less was more. Work it out with your doctors, tinker (with their cooperation), and find a balance that works for you. Everyone is on different drug cocktails, and everyone's body is different. There won't be a definitive answer here, or anywhere. Trust yourself, work with your doctors. You'll get through this.
...chemo is not very much fun, but they should be able to help you make it tolerable at least.
posted by Stagger Lee at 7:57 AM on August 7, 2013
I need help articulating a question for my doctors that will help me to keep my stomach calm, while leveling my head as well.
"During my chemo this weekend, I had such profound and frightening nightmares that the feelings persisted for days. I can't cope with undertreated nausea but I can't cope with those dreams, either. Could we please review my meds to try to get these side effects under control?"
I don't think there's a lot of benefit to your trying to figure out what regimen you need on your own, which is sort of what your point-by-point there sounds like - you sound like you're caught in the anxiety (which is perfectly understandable, especially given the lingering terror from the nightmares) and that's going to make it even harder to try to get your head level enough to try to ask for help. Keep it simple - if your care team is good, your level of distress (which is abundantly clear to me just from your post) will make it clear that this is a big priority in your treatment.
You can do this. Good luck with your treatment.
posted by gingerest at 1:35 AM on August 8, 2013
"During my chemo this weekend, I had such profound and frightening nightmares that the feelings persisted for days. I can't cope with undertreated nausea but I can't cope with those dreams, either. Could we please review my meds to try to get these side effects under control?"
I don't think there's a lot of benefit to your trying to figure out what regimen you need on your own, which is sort of what your point-by-point there sounds like - you sound like you're caught in the anxiety (which is perfectly understandable, especially given the lingering terror from the nightmares) and that's going to make it even harder to try to get your head level enough to try to ask for help. Keep it simple - if your care team is good, your level of distress (which is abundantly clear to me just from your post) will make it clear that this is a big priority in your treatment.
You can do this. Good luck with your treatment.
posted by gingerest at 1:35 AM on August 8, 2013
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I've been through chemo twice, and I can tell you that with experience, you will figure out how to stop hyperfocusing on the near-term. You will "get" that there is a full day, maybe two, of intense flu-like symptoms, including the nausea. Including the nightmares! They are only that, nightmares.
You will know start to understand and anticipate what's coming, you will prepare yourself, you will adapt. You WILL be able to ride it, I promise.
I promise.
Tell your doctors just what you said here, but lose the judging of yourself. You gotta get through. They can help.
posted by thinkpiece at 12:09 PM on August 6, 2013 [1 favorite]