Hello all...I need to know if it is "normal" to experience increased nausea and vomitting after completing radiation therapy. Jim finished his last (43rd) radiation treatment yesterday, and starting last week he has had an increase in nausea and vomitting...it is so hard to tell what is making him sick to his stomach

I had pretty much the same experience when I finished radiation. You didn't mention constipation, it also causes nausea and vomiting. Was it the radiation? I don't know - the mucous, poor hydration, pain meds, other meds, laxatives, mouth sores still don't know. I would run it by the doctor, they would prefer he not get sick. Oh, and did I mention that the "Pink Magic" makes me gag and vomit everytime I use it. I also needed to be rehydrated twice (but not weekly). Fluid intake is the most important thing you need 2-3 liters a day - that's 4-6 personal size water bottles in other words, a lot. Make sure he stays hydrated. Stay away from drinks with caffeine.
Is he done with chemo? After my second session I had to use compazine suppositories because I couldn't keep anything down (after the Zofran stopped being effective - about 72 hrs) He needs to have multiple types of antiemetics in his inventory. I have to tell you, I have thrown up more in the last 3 months than in my entire life combined - I'm actually getting used to it.
It IS frustrating when you have worked hard to intake the calories than lose them. Wait till after three weeks out and you will be celebrating the end of treatment.


Gary
----------------------------
IMRT/Cisplatin X2
SCC, Stage III, Right Tonsil
Treatment began Jan 27, 2003
Treatment ended Mar 20, 2003

Gary,
Thanks for the info...he does also have constipation, he does not use the "magic mouthwash" though, he can't even rinse/gargle with the soda water much at this point...he hasn't been able to get anything down his throat since about week 4 of radiation (3 weeks ago or so) not even sucking on ice chips, which used to be tolerable. He gets a liter of saline at the docs each day M-F, I have a hard time getting alot of extra fluid in him since I can't even manage to get the amount of food (Jevity only now for 4 weeks) in him that we are supposed to...UGGH...Jim has had 4 rounds of chemo on a 28 day cycle (Taxotere/Cisplatin/5FU) we were initially supposed to do two more rounds after radiation but chemo doc is not sure...we will talk to him this week about it. Jim managed the nausea very well during chemo., this nausea and vomiting is quite a bit worse than the chemo stuff ever was...thanks for the encouragement Gary, we will keep plugging away at this...

Jan,
Want you to know that it does get better..have faith. My husband is finally feeling better after about 7 weeks post radiation and chemo. He had alot of nausea and vomiting, too, for awhile there. Still does once in awhile. But is now managing almost 3000 calories per day (Novasource, mostly) through PEG. He has gone from spending most of the day (post treatment) in bed to just taking an hour or so nap every day. It will get better. I know it's frustrating because you count down the days until treatment is over...and then you are hit with the post-treatment blues.

Anita

Jan,
My diagnosis and treatment were almost identical to your husband's. I have said many times on this board...the absolute worst time for me was when I finished my radiation. You ring the bell, smile and head home after going to radiation treatment every day and then twice a day. You expect that things can only look up from here. Unfortunately, the radiation keeps on working on you ( sort of like a microwave ) after treatment ends, and for most of us, we enter our most difficult period. I was nauseous once or twice then and felt depressed and bad generally.

The good news is that it starts getting better and your husband will be much improved in a couple of weeks.

Best of luck
Dann G.

Jan,
Constipation will shut down eating and drinking also. It happened to me for 2-3 days in a row and that's when I really lost weight. Probably should have gone to the hospital. I was still in treatment then. It has been my biggest recurring problem of them all (besides Thrush). I've been using Peri-Colace with satisfactory results.
If his swallowing is really painful ask the doc for a script for "Pink Magic". There are variations the stuff I have is lidocaine, morphine and mallox.
Also, check the archives for posts on feeding tubes - there are do's and don'ts with them.

Thanks Anita, Dann & Gary...
The encouragement is much appreciated...it seems like what may be happening with Jim is that his throat is almost closed...he can't swallow anything, and the mucous is so abundant and thick that he needs to clear his throat constantly. He will usually only sleep in 30 minute increments, then wakes and starts clearing his throat and that leads to the gagging and then...well, I thnk you get the picture. We started taking salagen by tube on Friday, which I thought might help thin the mucous, so far it doesn't seem to be helping and Jim wants to stop taking it because he wonders if that is making his gagging worse. ??? Gary, yes, we too have had a hospitalization due to the constipation and inability to feed with the tube...we thought we had the constipation under control, things are moving, albeit slowly...he has lactulose at 30cc 3times daily, and senokot liquid a couple times a day, then about every three days if things aren't moving he has a dulcolax suppository...I never thought I'd be so well versed in laxatives and bowel stimulants ! He also takes Reglan which is supposed to help move things through his stomach or something. Well, today he was sick to his stomach 3 times, I'm hoping for an improvement tomorrow. Thanks for listening to me...all of you are a great support.

Jan,
The mucous begins to thin also. I slept with a yankauer suction machine next to my bed that I would use to clear the mucous each time that it woke me up. A few months later I no longer needed it and began complaining about the dry mouth waking me up instead of the mucous. This too will pass.

Danny G.

I have found also that sleeping on your back slightly propped up also helps a little. With me the problem is always worse in the morning. I think the humidifier helps also. It seems like it is stuck in the airway and it won't close completely to seal when I'm eating or drinking. If I eat or drink than I end up choking like it went down the wrong pipe. If I really want to hack it up, I have to lay on my back. Once most of that stuff is gone I can usually eat drink & speak ok. It got better about three weeks after the end of radiation -hang in there - it'll get better. I tried Senekot in the beginning and it was worthless! The Peri-Colace seems to work the best and fastest. I suspect that laxatives may be adding to the nausea also - you can't win in this game. I can certainly relate and empathize because I know just how miserable this stuff can make you feel. It really is a nuisance but a small price to pay for survival. And like Danny said "This too shall pass". And also like Danny, now when I wake up everything is stuck together from dryness! The problems just kind of morph along - standard opersting procedure. I figure God wants to teach me all about patience - my biggest character defect. LOL

Thanks you guys! I'll pick up some Pericolace today and see if it works better for us. We asked Jim's radiation doc about the yankauer suction and he wasn't for it, but he hasn't been for alot of things that we wanted to try like amifostene and salagen during treatment...I guess we could ask Jims chemo doc if he would write an rx for one (is that how it's done to get insurance to cover it?)

I am surprised that oncologist isn't the primary care physician at this time. While I was in chemo
and still, he is my primary doc which means he controls and oversees all the meds and writes the scripts, not that that Rad Oncologist doesn't -she gives an occasional script. Considering the overwhelming effects on the entire body from the chemo, it makes sense that things are structured this way.
Once I am released from the Oncologist and Radiation Oncologist, my primary care doctor will revert back to the Head and Neck surgeon. My HMO also has an "advice nurse" coodinator system where I can ask any questions, get scripts written 5 days a week, 8 hrs. a day, and it has worked really well. By the way, check with the oncologist, but I don't think you want to continue Reglan if you are not in the chemo cycle.
To show you how wierd this disease is - I felt great last night, had a good morning and in the blink of an eye got sick to my stomach, now I feel alright again.

Most medical devices are "presciption" which means they must be ordered by a physician.