Everyone knows that chemo makes people feel nauseated and often leads to the terrible side-effect of vomiting. Fortunately, many drugs have been developed to help significantly reduce nausea during cancer treatment. We learned first-hand that palliative care can result in substantially reduced inpatient stays – a positive side-effect of this chemo side-effect.
When my daughter had leukemia the first time, she was only two and a half years old. Zofran and Benedryl were sufficient to help her through her bouts of nausea. When my daughter relapsed, at thirteen years old, the chemo cocktails were increased substantially. She also received chemo and steroids in her spinal column because of her CNS3 relapse in her spine. Her nausea and vomiting were intense. She lost twenty-five pounds during the first month of her treatment using only Zofran and Benedryl.
We then learned about Emend, a newer anti-nausea medicine that was FDA approved only for adults. Because my daughter was adult-sized, the doctors agreed to try it. During Induction 2, she had to endure four high-dose methotrexate treatments, one a week for four weeks. During our first inpatient stay, she was given Zofran and Benedryl to combat nausea. It was a hellish, five-day inpatient stay before her levels cleared enough to go home. Almost a whole week! For the remaining three high-dose methotrexate treatments, we used Emend, in addition to Zofran and Benedryl. The difference was miraculous. Because of Emend, she could eat during the chemo drip – unheard of in the previous high-dose treatment. Eating the food helped her clear the methotrexate so much faster. Using Emend literally cut our inpatient stay in half, from five days to two and a half days. As an added bonus, she could sit up and talk and watch TV throughout the treatment; she no longer curled up in the fetal position for days at a time.
I understand the risk I took to administer Emend to my child as a non-FDA-approved drug, but the benefits were unbelievable. First, the cost of the inpatient stay was cut almost in half. Second, we now had two and a half days more to be together at home as a family, instead of being split apart by the hospital visit. Third, and some would argue most important, the treatment was MUCH easier for my daughter. Throughout the remaining two and half year treatment, I used to wonder if her success would be compromised because the methotrexate passed through more quickly than the protocol was designed for – would it be too quickly? But she survived the protocol, so it turned out to be a good decision.
This demonstrates that palliative care not only increases the comfort level of patients but that it can reduce the length of stay during a hospital or clinic visit.
How integrated is palliative care in your cancer program? How much do you emphasize improvements in palliative care to improve the patient’s experience?
Please call primeASCENT today to help you use palliative care to improve the efficiency of your cancer center as well as the patient’s experience.
Yours in Oncology Excellence,
Christina Schilstra
Guest Blogger
If you have any questions, contact primeASCENT by calling 410-444-6024 or click here today!
