My view is ask for Emend if this is something which will make you feel less nervous about the whole thing. When I had my consultation initally my onc asked me what if anything I was most worried about and I said straight away that I couldn't cope with feeling sick. I am totally pathetic and readily admit to this. She said she would guarantee that I wouldn't feel sick and she would give me enough anti-sickness.
I was on Emend, plus 3 others plus the general Domperidone and I took them religiously as directed. I didn't wait to feel slightly nauseous or anything.
Would I have felt sick without them - who knows but I certainly wasn't prepared to take the risk. As I was having chemo every 2 weeks, not 3 I didn't get much recovery time either.
Pure and simple, they try to discourage Emend on the NHS because it is expensive. Same with Neulasta jabs whilst on Tax for the bone pain. These come in at £1000 each. I had my treatment privately and Bupa were billed £500 for my Emend tablets for eash session.
But if you ask for it you should get it. Remember, it is all about getting through the chemo. You don't get extra medals for copying without and trying to be a hero. And don't worry about ruffling feathers, at the end of the day you are going through it, not the nurses - they don't know what it is like unless they have been through it themselves.