The effects of anticancer drugs vary from person to person and dose to dose. A drug that makes some children violently ill often has no effect on other children. Some drugs produce no nausea until several doses have been given, but others cause nausea after a single dose. There is no relationship between the amount of nausea and the effectiveness of the medicine. Because the effects of chemotherapy are so variable, each child’s treatment for nausea must be tailored to her individual needs.

Antinausea medications help prevent or minimize the amount of nausea and vomiting associated with chemotherapy. Many children eat normally and never exhibit any signs of nausea while on chemotherapy because of the effectiveness of the antinausea medications. For a discussion of drugs used to prevent nausea and vomiting, see Chapter 13, Chemotherapy and Other Medications.

Following is a list of suggestions for helping children and teenagers cope with nausea and vomiting:

• Give your child antinausea medications as prescribed. Nausea is easier to keep under control than to get control of, so never miss a dose.

During Christine’s treatment, nausea was a big problem at first. I made a point to work with the staff to address this, and this is the plan we came up with: Christine would be given the maximum tolerated dose of Zofran® the first time chemo was administered, then four hours later she’d get the regular dose, then we would give the regular dose every six hours.

• Have your child wear loose clothing, because it is both more comfortable and easier to remove if soiled.
• Try to have at least one change of clothes for your child in the car.
• Keep large zip-lock plastic bags in the car. They are an easy-to-use and highly effective container if your child gets sick. They can be sealed and disposed of quickly and neatly, ridding the car of unpleasant odors that could make your child’s nausea worse.
• Carry a bucket, towels, and baby wipes in the car in case of vomiting.
• Try to keep your child in a quiet, well-ventilated room after chemotherapy.
• Try not to cook in the house when your child feels nauseated. If possible, open windows to provide plenty of fresh air. Smells can trigger nausea.
• Use a covered cup with a straw for liquids if your child is nauseated by smells.
• Do not serve hot foods if the odor aggravates your child’s nausea.
• Serve dry foods such as toast, pretzels, cereal, or crackers in the morning or whenever your child is feeling nauseated.
• Serve several small meals rather than three large ones.
• Have your child keep his head elevated after eating. Lying flat can make nausea worse.
• Provide plenty of clear liquids such as water, Gatorade®, and ginger ale.
• Avoid serving sweet, fried, or very spicy foods. Instead, stick with bland foods such as potatoes, cottage cheese, soup, bananas, applesauce, rice, or toast when your child feels nauseated.
• Watch for any signs of dehydration, including loose or dry skin, dry mouth, sunken eyes, dizziness, and decreased urination. Call the doctor if your child appears dehydrated.
• Have your child rinse her mouth with water or a mixture of water and lemon juice after she vomits to help remove the taste.
• Let your child chew gum or suck on ice pops if he develops a metallic taste in his mouth; it may help alleviate the taste of metal.
• Consider trying acupuncture, aromatherapy, massage, or meditation to help alleviate symptoms.

Meagan has always had problems in every phase of treatment with stomachaches, especially in the morning. She will often vomit once and then be over it. She is frequently soothed with just rubbing her tummy or laying a hot towel on it.

If antinausea medications do not work well for your child, investigate the U.S. Food and Drug Administration-approved Relief Band®. This wrist band gives an electrical stimulation (too faint to feel) to an point on the wrist that affects the portion of the brain that controls nausea. Information about this band is available at www.reliefband.com. A similar product that works well is the Sea-Band® (www.sea-band.com).