The first change - we are switching from Paclitaxel to Abraxane, which a a protein bound form of Paclitaxel. This form is easier to "stomach". The Abraxane will be taken in smaller doses every week, rather than a huge dose every 3rd week. That, too, may make it easier to tolerate.
Another difference is that Rudy is no longer on any pain medications. Fentanyl was started the same day as Round 1 of chemo. If it was a main culprit in the after-chemo vomiting, then we don't have to worry about that one on this round.
There will be some substantial anti-nausea meds given the day of chemo. An anti-nausea med was used with Round 1 as well, but it didn't work against whatever thing Rudy was reacting to. Since two things are being changed that could have been the cause of the nausea in the first place, hopefully, the anti nausea IV will not fail this time.
One other difference will be the medications used to treat any nausea that does occur. When Rudy was having such a hard time after the first round, he was never seen by a doctor during any of the following days that we kept returning for fluids. The nurses were left guessing and did the best they could. They prescribed this and that and at one point he was taking 4 different nausea medications at one time and there were others previously tried still in his system. Two were oral, One was a patch. Another was a cream. We were told they each worked in different ways. Their reasoning was that the combination would attack the nausea from many different angles. That sounded good to us, so we followed instructions, desperate to do anything we could to help end the vomiting.
Dr. Thompson and her assistant, Stephanie, looked fairly incredulous about all of the meds he was taking for nausea. They said that taking all of those together could have actually worked against him and prolonged the vomiting. Hopefully, the preventative things being done will keep us from ever having to deal with uncontrolled vomiting again.
