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Getting through the 1st chemo s...

From the perspective of the caregiver, I would this check-list would help the caregivers.


Pre-chemo checklist


Visit the dentist to ensure you have no dental problem. Most dentists would not do any dental work on you while you are on chemo as your gums would be especially prone to bleeding.


Read up about the side-effects of the chemo medication used. Different chemo medications have different side-effects. Do a search on the web/check with hospital how to manage the side-effects.


Check with the hospital how long the chemo session would take and frequency of treatment. Also check with hospital the dosage of medication used.


The evening before the chemo and the day of the chemo, the patient has to take 5 pills – steroid which would help to counter any allergy is any.


Bring some water other than plain water (which you can get from hospital) – some suggestions include home-made barley drink (to ‘cool’ you down from the toxicity of the chemo), cranberry juice (purportedly helped the chemo to work better on the cancer) or fruit juices that are low in acid (e.g. banana, apple, watermelon, and honeydew)


Get some reading material, MP3 player or anything to occupy your mind the chemo session.


Understand the process of the chemotherapy and tell the patient of the process so that you would not go to the chemo room blindly not knowing what would take place.  The first packet of medication the hospital used is not the chemo medication – rather it is something that would keep the allergy to the chemo + medication that would make you sleepy. For my mum, as the nurse explained exactly what she is doing step-by-step, my mum knew exactly what was going on and it settled her fears. Just to share an incident at the 1st chemo session my father has – after a few minutes the needle was poked to him, my father started to panic and said he felt ‘strange’ and ‘uncomfortable’. The nurse looked at him and said that she has not even ‘turn on’ the drip. We had a good laugh after the treatment but this shows how much fears and undercertainties the patient faced. Knowledge of the process would certainly help to clam the patient’s fears.


Check with the hospital whether they would be providing lunch or do you need to pack your own lunch.


Get something sour tidbits to chew during the chemo – it would help you to keep your stomach down if you feel nausea. Some suggestions – preserved prunes, orange peel, lemon/orange flavor hard candy.


Get a few paper/plastic bags – in case the patient throws up during the chemo or during the journey back home.


If you are taking other medications and vitamin supplements, consult your doctor prior the chemo sessions.


Buy a soft toothbrush to clean your teeth – chemo would really make your gums sensitive.


During the chemo


A blood test would be done prior to the chemo to ensure that the blood count is okay. The test result typically takes 1 hour to be ready .


Do get the nurse to explain the whole chemo process again. You and the patient would probably be too nervous to remember anything – and it really calmed mother when the nurse took the time to explain the entire process.


Confirm with the nurse the sort of chemo medication used, the amount of time the chemo process would take as well as the dosage. This is to prevent any possible mistakes due to human error.


When the patient is on the drip, ensure that there is no redness/hotness at the area where the needle poked in. If there is pain or swelling, the needle is not placed correctly. Alert the nurse to adjust the drip.


Signs to watch out for – breathlessness/panting, face turning red, feeling extreme heat/cold – call the nurse immediately as this may be an allergic reaction to chemo


Ensure that the patient take seeps of water every half and hour.

Get the patient to go to the toilet every 1-2 hours. If she has been drinking water, peeing should not be a problem and this would help the body to clear the toxins. Walking around would freshen up the patient and not dwell too much on the chemo session.  



End of chemo #1

Let the patient rest for a while after the removal of the drip.


Ask the patient to go to the toilet to pee.


Check with the nurse for the emergency number to call if the patient is sick at home. Call the helpline immediately if the temperature of the patient reaches 36 degrees Celsius at any time or the patients have symptoms of infection such as chills, severe cough, sore throat, burning sensation while passing urine, having persistent diarrhea or shortness of breath and having mouth ulcers for more than 3 days



**** I understand that some patients require a shot of Neulasta 24 hours after the chemo to boost the blood cell count. For some patients, they may also require a blood transfusion . I cannot comment on this as my mum never did suffer from a drop in blood-count during the chemo.


**** Maybe some kind soul would put up an article on managing the side-effects post-chemo? I do have some pointers but I need to tidy them up before they are readable!


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