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Some approaches you can take to help prevent or control nausea and vomiting include: • take antiemetics 30 minutes prior to meals • minimise the use of products with strong smells such as perfumes or certain cleaning products • avoid eating or preparing food when feeling sick. If possible have someone else do the cooking or try to prepare and freeze meals in advance for those days when you do not feel like cooking • eat small amounts of food more frequently – commonly called grazing • eat bland food rather than strong smelling or spicy food • avoid high fat, greasy and fried food • drink plenty of fluids throughout the day (small amounts regularly) • avoid drinking too much before a meal • avoid alcohol and high volumes of coffee • ginger may help with nausea; try biscuits, tea or ginger beer • peppermints or peppermint tea may help When should I seek help from a health professional? If vomiting becomes severe or occurs frequently within the first 24 to 48 hours, please contact your health care team. Always seek medical advice if you: • have nausea that lasts for more than a few days, or if the nausea keeps you from doing things that are important to you • vomit more than once or twice a day for two days • cannot keep any liquids or food down for more than 24 hours • show signs of dehydration: • reduced urine output • rapid heart rate • headaches • flushed, dry skin • coated tongue • irritability • confusion • dizziness iconcancercare.com.au Nausea and vomiting What is it? Cancer and the effects of treatments can increase the risk of infection. Neutropenia is when white blood cells, called neutrophils, are low. Neutrophils are a type of white blood cell that helps fight infection. The lower your neutrophil count drops the greater the risk of you developing an infection and the harder it is for your body to deal with the infection on its own. What causes it? Chemotherapy affects the rapidly dividing cells in bone marrow where new blood cells are formed. Diseases such as leukaemia, myeloma and lymphoma directly affect the bone marrow and interfere with the formation of infection fighting cells. What are the signs and symptoms? You may have blood tests at different times throughout your treatment to check on your neutrophil count. The signs and symptoms of an infection may include: • a temperature of 38oC or above • chills or shakes, unusual sweating • cough with yellow or green coloured sputum, shortness of breath • sore throat, sores in your mouth • redness or swelling on your skin (particularly around a central line) • loose or liquid bowel motions • passing more urine than normal or a burning feeling when is passing What it? urine • blood or discharge in your urine sick or queasy and vomiting (throwing up) •Feeling discharge from your(nausea) eyes or ears common problem for people being treated for cancer, •is avaginal discharge and/or itching however it can be well managed and controlled. • flu-like symptoms such as body aches and feeling tired What causes it? and/or manage it? How do we prevent Nausea and mayorbeavoided causedwith by the cancer itselfof or Neutropenia canvomiting be reduced administration the treatment you are receiving. Chemotherapy drugs vary growth factors such as granulocyte colony stimulating factor in theItincidence andwith severity of nausea vomiting they (G-CSF). is only used certain types ofand chemotherapy. addition it may andfor how long Yourcause, doctorinwill decidetoifhow this quickly medication is start suitable use in it lasts. Emotional factors such as anxiety or anticipation your situation. may also influence whether a person feels sick or not. Other If your neutrophilmay count is low or to normal, medications increase thehas risknot of returned nausea and vomiting, yoursuch doctor may delay your next treatment or the dose of ants. as, pain medications, antibiotics, antifungals and chemotherapy you are given may be reduced. Your doctor will make these decisions based on your individual circumstances. Neutrophils are commonly at their lowest point 7-14 days What are the signs and symptoms? After chemotherapy, some people develop nausea and vomiting within minutes or hours while others may develop symptoms two to three days later. The nausea and vomiting may last for up to 24 hours or in some cases can last up to seven days. Some people feel sick before their treatment or when a circumstance such as a smell or sight reminds them of their treatment. This is known as anticipatory nausea and vomiting. Associated with nausea and vomiting, you may look pale and experience sweating and excess saliva. How do we prevent and/or manage it? There are a number of medications available to treat, prevent or control nausea and vomiting. These medications, called antiemetics, can be taken as a tablet, a wafer, given by suppository or given into a vein through a drip. Often a combination of different types of antiemetics will be given. Antiemetics will be given before chemotherapy and then you will be given some tablets or wafers to take home. It is important that you take the medication regularly, as directed by your doctor. If the medications you are given don’t seem to be working well for you, you should speak to your health care team as a different medication might work better for you. • hypnosis may be effective for anticipatory nausea and vomiting • progressive muscle relaxation in combination with guided imagery is likely to be effective • progressive muscle relaxation (PMR) is a technique of alternately tensing and relaxing muscle groups in sequence throughout the body • guided imagery involves the use of mental visualisation and imagination to enhance relaxation and alter specific experiences Strategies such as aromatherapy, massage, exercise, acupressure and acupuncture may help but their effectiveness remains unproven. Talk to your health care team if you are interested in more information about any of these techniques. Every patient is different, please discuss your own personal situation with your treating doctor.