The Do's and Don'ts of Chemical Aids ( i.e. Medications)

This week we, and by that I mean me and Joe, learned a valuable lesson on how to take prescribed medications.  First let's go back to give a little history.

The first chemo that Joe was on was Zeloda.  This came in pill form and other than two anti-nausea medications, heretofore referred to as the Cadillac and the Ford, he required no other medications (basically).  After the surgery he began the liquid, IV infused chemo, Gemcitabine and continued to take the Cadillac and Ford as needed.  When he went to Duke for the infusion, they also gave him various fluids including steroids to help combat the negative side effects of the chemotherapy.  After the surgery he also was given a prescription for pain medication (I won't mention the particular name but let's just say it works).  After the first couple of weeks of this chemo regimen it became obvious that it was difficult to sleep for the first few nights after the infusion due to the steroids.  Because of that, he was given a prescription for a sleep aid - Ambien.  At first he took just one.  That didn't work so he would take a second.  Then usually a third along with a couple of Benadryl and often some "Sleepy Time" tea.  This became the norm for chemo night.  The next night he would take just two Ambien and then the next night just one.  Since his chemo at that time was on Thursday mornings, by Sunday night, he needed no sleep aids at all.

Like I said this became the routine.  Joe had originally resisted the idea of the Ambien because as he put it, "he didn't want to get up in the middle of the night and eat a whole chicken", referring to reports when the drug first came out of people sleep walking, eating and driving after taking Ambien. Why he thought there might be a whole chicken in the house still confuses me.  Needless to say he got over that quick enough.  So that has been the routine for over a year.  Back in August however, after discovering the tumor had grown and some lesions had appeared on his liver, he was switched to a more aggressive chemotherapy regimen.  He only had the one infusion before he was hospitalized a couple of weeks ago for a bacterial infection.  This past Monday, he had the second infusion.  Apparently Joe felt there was no need to alter the way he typically treated the night of his infusion because Monday night, very soon after throwing up (I think that is an important element of the story - empty stomach- also loosing the Cadillac he had just taken) he took his three Ambien.  This was around 9:00 - 9:15 pm.  Within 15 minutes, just after brushing his teeth and sitting on the side of the bed, he began to get a little "loopy".  By that I mean he was barely able to sit up and was talking nonsensical stuff.  I however, got him in bed.  One key component to this story is that Joe is hooked up to a "take home" chemo infuser.  He has a tube running out of his chest and into a small bottle filled with 5-flu chemotherapy for 46 hours.
 The bottle fits snugly into a little bag that resembles a small purse.  He can either wear the bag by hanging the strap around his shoulder or around his waist.  He ops for the shoulder,  however when he is in bed, it hangs from the headboard of the bed.  So here is Joe laying in bed with his little bag on the headboard.  This is when the fun really cranked up. (that sentence is dripping with sarcasm). Joe starts having conversations.  With who I'm not sure.  Periodically he however will ask me questions.  What was going on in his head? I don't know, but there was some crazy crap coming out of his mouth! He was talking about Lady Bird Johnson's hats, Katie Couric & Barbra Streisand, whether or not there were "ready made" pizzas at Papa Johns and the need for us to measure the pillows at Duke.  There was a lot of other stuff thrown in there that I could not understand too.  Throughout this period, Joe also decided to get out of bed to go to the bathroom. Without taking the chemo bag off the headboard.  I'm yelling at him to stop and grabbing him by the arm to prevent him from pulling the IV out of his port (if there is a chemo spill we literally have to call 911 and get a haz mat crew out to the house).  Of course once he does get in the bathroom, he decides he doesnt have to go after all so back to the bed we go...for more chatter.  By now it's going on midnight and I'm starting to get a tad bit on the scared side.  Just before 1a.m. Joe decided he wanted to get up again but by then I had a firm death grip on his arm and would not let him up.  He then nodded off for a while and somewhere just before 2a.m. woke up and asked me what I was doing awake.  I told him I was just getting ready to go to sleep and for him to roll on over and go back to sleep.  The tone in his voice was that of Joe, not the crazy person who had laid beside me for the last 5 hours.  Why did the Ambien effect him differently this time?  Who knows.  Possibly he isn't getting the same amount of steroids or perhaps different steroids.  Regardless, he will NOT be taking three at a time again.  I can laugh now, but Monday night I was not amused.

Another lesson learned this week, don't take his pain meds on an empty stomach like he did on Sunday.  You should not take one pill, let alone six - although spread out all day.  He probably would have been much better off to have taken one pain pill and eaten something than to have gone straight to bed after church and taken his prescribed dosage throughout the afternoon and evening.  At the very least he wouldn't have been so sick to his stomach.  But now he has a new pain med prescription that hopefully will be more effective if his back pain returns.  But even then, he will eat too!

3 AMBIEN = CRAZY PERSON

6 PAIN MEDS - FOOD = NAUSEOUS PERSON