Download Anticipatory Nausea and Vomiting - ICID (Salisbury)

i
If you need this
information in another
language or medium
(audio, large print,
etc) please contact
the Customer Care
Team on 0800
374 208 email:
customercare@
salisbury.nhs.uk.
You are entitled to a copy
of any letter we write about
you. Please ask if you want
one when you come to the
hospital.
If you are unhappy with the
advice you have been given
by your GP, consultant,
or another healthcare
professional, you may ask for
a second (or further) opinion.
The evidence used in the
preparation of this leaflet is
available on request. Please
email: patient.information@
salisbury.nhs.uk if you would
like a reference list.
Author: Kate Jenkins
Role: Clinical Psychologist
Date written: December 2009
Last reviewed: May 2013
Review date: June 2016
Version: 1.1
Code: PI0437
Anticipatory Nausea
and Vomiting (1 of 2)
What is anticipatory nausea and vomiting (ANV)?
ANV occurs in about one-third of patients who receive chemotherapy.
It happens when your body starts to associate certain triggers (such as
the location of the waiting room, or certain smells) with feeling sick.
Chemotherapy itself can make people feel sick. Sometimes reminders
of the place where you had your chemotherapy can also make you feel
sick. This is because your brain associates the place, smell or other
reminders with feeling sick. This is a natural reaction in the same way
that your mouth starts to water when you smell food.
There are medications available that are designed to help with this, but
often these are not effective and the techniques that are suggested in
this leaflet may be more helpful than medication and work for longer.
They may also help you when you feel sick but do not have any
medication available.
There is also a link between how stressed you are and ANV. This is
why some of the measures that are designed to prevent ANV include
relaxation exercises. Your brain gets used to feeling anxious and
nauseous in the hospital setting even after just one or two occasions,
so just walking into the hospital may trigger these reactions. Stress and
anxiety increase the levels of adrenaline in the body, which can also
contribute to nausea. This is why the relaxation exercises are aimed at
reducing adrenaline levels.
If you have any specific anxieties, such as a fear of needles or the sight
of blood, please mention this to one of the nursing or medical staff as
soon as possible.
Other things may make you more likely to be at risk of ANV, so please
mention to the staff if any of the following apply to you:
• severe travel sickness
• severe nausea after your last chemotherapy session
• if you would describe yourself as a generally anxious person
• if you suffered from severe morning sickness during pregnancy
• if you felt lightheaded, dizzy, or hot and sweaty after your last
chemotherapy.
If you expect to suffer from ANV, or if you do already, mention it to the
staff on Pembroke Suite as soon as possible, as there are some simple
things that can help.
Clinical Psychology
01722 425105
© Salisbury NHS Foundation Trust
Salisbury District Hospital, Salisbury, Wiltshire SP2 8BJ
www.salisbury.nhs.uk
Anticipatory Nausea and Vomiting (2 of 2)
Self-help strategies
Rating anxiety - learn to rate your anxiety on a scale of 0 (not anxious at all) to 100 (the most
anxious you have ever been). You can then keep a track of your concerns and see what helps,
as well as identifying trigger points.
Relaxation imagery exercises - these are available on the Suite for you to use in the waiting
room. If you have your own MP3 player we can upload them for you to take home with you, or
we can give them to you on a CD.
Muscle relaxation exercises - these will help to reduce tension in your body.
Breathing exercises - these help to bring your adrenaline level down, which will help with
nausea as well as helping to relieve feelings of anxiety.
Changing the trigger - The Pembroke Suite has access to “alternative smells” that may help
decrease your anxiety and not feel sick - it often helps if you try a different smell each time you
visit the Suite or you can bring your own (for example a handkerchief with perfume on).
All these resources are available from Reception on the Pembroke Suite.
What if these aren’t enough?
If you have tried the self-help techniques, but you are still suffering from severe anticipatory
nausea or anxiety around your chemotherapy, you can ask to be referred to the Psychology
Department. Psychologists are experts in a technique called cognitive behaviour therapy (CBT),
which is a very successful treatment for the most severe ANV. The psychologist will work with
you to try to identify your trigger points and to change your physical and emotional reactions to
them. You and the psychologist will work together to find the approach that works best for you,
to help to make your experience of chemotherapy less stressful and unpleasant.
Clinical Psychology
01722 425105
© Salisbury NHS Foundation Trust
Salisbury District Hospital, Salisbury, Wiltshire SP2 8BJ
www.salisbury.nhs.uk