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amy b Offline OP
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Hi. I need some help please. I know this is going to be long and I apologize in advance, but I need some real-life input, as opposed to Dr and Nurse Practioner input.

My mom finished treatments four weeks ago today. She lives at my house so that she could be close to the hospital for treatments. (My husband is a saint.) I don't even know where to start. She does not want to get out of bed, makes no effort to do anything to get herself better, will not speak (she has a trache, but also has a speaking valve that she could use if she wanted to), does not want to see anyone other than me and my sister, who helps care for her every other week, does not read, only goes for one tiny walk outside a day (and that is with a HUGE fight), and just flat out refuses to do anything to make herself get any better. She has a peg tube and will not do her own feedings and waits for one of us to get up in the middle of the night if she is coughing and needs meds or just needs to sit up in bed. If she vomits, which still happens occassionally, mostly from mucous, she just waits for me and hands me the pail full of mucous.

I realize it will take awhile for her to get back to herself, but she has become, and helped herself become, so weak that she can barely walk a few steps. The plan was to have her go back and live in her own house on October 1. My sister has been using FMLA leave and my job has been more supportive and flexible than I ever would have imagined, always with the thought that about 6 weeks after treatment she would be back at home. At this rate I honestly believe that if I took a year off of work or even quit she would be in the same state a year from now. She just makes no effort. The current plan is to get a live in nurse for her to have at her house starting mid October after her scans. She does not like the idea, but I think it will be the only way for her to get better.

Is this type of behavior and lack of caring on her part normal? She does not even wipe up her own mucous. She is on Zoloft as well as anxiety meds (along with the rest of the normal arsenal of meds). Any thoughts on what I should do? Is this normal?

I really appreciate any and all help anyone can provide. Am I being unrealistic that she should make an effort at this point - 4 weeks out?

Thank you, thank you, thank you. I don't know what I would do without all of the knowledge on these boards.

Amy


Caretaker to my best friend, my mom. Age 60 - never smoked or drank. St IVA oropharynx. 37 radiation tx, 8 carboplatin tx. Diag 5/31/07-TX completed 8/16/07-good PET 10/10/07. Passed away 3/28/08 due to weakened blood vessels from tx. Now watching over her triplet grandsons born on 5/19/08.
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Amy, I can tell you that four weeks out I was feeling pretty miserable physically, and probably even worse mentally because at that point I had been feelings really miserable for so long (a couple of months) that it seemed like it would never get better. I think saying that your mother "would be in the same state a year from now" shows a pretty strong lack of understanding in terms of just how bad this treatment can make you feel and how long after it's over you feel bad. Radiation is the gift that keeps on giving and it is only around now that she should start to notice any improvements--many people get *worse* for several weks after radiation is over--and the improvements that do start to happen will probably be very gradual.

On top of that, the ant-anxiety meds and the zoloft, while they may be keeping her from serious depression or panic, could also be making her kind of indifferent to things she might normally care about.

I agree with you in pushing the "tiny walk outside" every day, and in pushing for her to feed herself and learn how to do her own meds, but please try to lower your expectations about how she should be feeling right now. And try to put yourself in her shoes--you are frustrated with how long it is taking her to show any improvement but you aren't the one in pain,vomiting phlegm and comptely fatigued by the radiation--just think how frustrating it must be for HER that it takes so long to feel better.

Nelie


SCC(T2N0M0) part.glossectomy & neck dissect 2/9/05 & 2/25/05.33 IMRT(66 Gy),2 Cisplatin ended 06/03/05.Stage I breast cancer treated 2/05-11/05.Surgery to remove esophageal stricture 07/06, still having dilatations to keep esophagus open.Dysphagia. "When you're going through hell, keep going"
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amy b Offline OP
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Nelie,
Thanks, and I honestly do realize (to the best of my ability) how awful she must be feeling. If you only knew her before she got ill... She was like Wonder Woman. I am not frustrated - I am concerned, as is everyone who sees her, including her nurse practitioners and doctors. That is why I was looking for some "real life experience" here. I would do anything to help my mom feel better and help her get better. But, given that I do not know anyone who has gone through this before, it is hard for me to know what is normal. I read this site and there is so much discussion of people pushing themselves to go back to work just weeks after their treatment, or at least looking forward to trying new things, and my concern was more that she lacks and and all of that motivation. I realize it will take time, I just want to make sure we are on the right track. Based on your experience it sounds like we are.

Thanks again,
Amy


Caretaker to my best friend, my mom. Age 60 - never smoked or drank. St IVA oropharynx. 37 radiation tx, 8 carboplatin tx. Diag 5/31/07-TX completed 8/16/07-good PET 10/10/07. Passed away 3/28/08 due to weakened blood vessels from tx. Now watching over her triplet grandsons born on 5/19/08.
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Hi Amy,

My dad went through a lot, surgery, heart attack, radiation...he too was superman prior to the cancer. He drove himself to every radiation treatment, forced himself to eat and drink, and just last week he got on his riding mower and cut the grass. His radiation treatments ended just two weeks ago.

I, like you, would be very concerned if this super human did a 180 after treatment. Sometimes medications need to be adjusted and can even have the opposite effect on people that they are supposed to. I would talk to your mother's doctors and let them know your concerns.

Everyone responds differently to treatment. This may just be more difficult for your mom to bounce back from than others, and still some people may experience worse symptoms than your mother.

Hang in there and consult with her doctors. They are the ones that can really let you know if what she is experiencing is normal.

Joy


CG to Father, 75 yo with SCC of the mouth; upper maxillectomy and neck diss. performed on 5/23/07. Father also suffered heart attack during surgery and now has CHF. RT complete on 8/28/07. Cancer back 11/27/07. RT and Chemo to start on 12/17. Cancer back 6/17/08. Finally at rest 08/08/08.
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Hi Amy,
I would ask the doctor about her zoloft. I have heard of a lot of people having issues with that med, I guess they could be referred to as adverse reactions. I know when my aunt was dealing with her lung cancer she was on that and she sat like a zombie until we had her med switched.
I hope your mom has a better day today. My mom who finished about the same time is up and down emotionally. She opted to not go on an antidepressant, she hated the idea of any more drugs in her system. She cries throughout the day....sometimes she looks at my kids and smiles and cries, the pets, the neighborhood kids...it's all so very emotional. Being her primary caregiver I can appreciate your concerns, this emotional rollercoaster is tough to watch. I don't know if you saw the quote somewhere here on the forum, I think it was from Petey-miss him sooo much!-- "Cancer depression is like driving a car on empty, you wonder when it's gonna conk out."
Hope today is a better day.
Donna


Donna
CG to Mom, dx 4/25/07 with tongue cancer,T3N0,tx began 7/6/07, 31 tx's of IMRT, 8 cycles of Erbitux. Brachytherapy, surgery, left neck dissection and temp trach placed all on 9/17/07, trach removed 10/17/07. ORN of jaw, late effect of radiation symptoms. **lost my beautiful mother on 5/5/11.
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Hi Amy,

Not sure of your mother's age or her possible other problems, but sounds like she is being a big baby. She has to want to get better. I suggest you tell her that you or your sister can no longer look after her and she must go to a long term care facility. I know the guilt will a problem, but she needs to understand she has to put forth some effort.

Tough love is hard but works.

Steve


SCC, base of tongue, 2 lymph nodes, stage 3/4. 35 X's IMRT radiation, chemo: Cisplatin x 2, 5FU x2, & Taxol x2. Hooray, after 3 years I'm in still in remission.
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Gee, I have to STRONGLY disagree with Steve and do agree wholeheartedly with Nelie. My 62 yr.old husband, who never slept more than 7 hrs in his life and loved working hard everyday, was knocked flat on his butt by 30 radiation txs. It took him over 8 weeks to feel like getting up and doing anything.[and he hated every minute of feeling that way- he kept a journal and every day for weeks there was an entry that read "I didn't make it up atoday, but tomorrow, I will get up and accomplish something"] He was not on Zoloff or any other mood altering drug during this time. Several things could be going on with your Mom. #1. Just the effects of the treatment are enough to have worn her out physically and emotionally, #2. The Zoloff and other meds might well be contributing to her lack of motivation, #3. The psychological effects of having to deal with this cancer may be more than she can handle. This is not like recovering from a tonsillectomy! I am sure this has added much stress to your household, perhaps youall need to re-evaluate how much care you can realistically provide and go from there. But., please don't lose patience with her at this point in her recovery efforts. Amy in the Ozarks


CGtoJohn:SCC Flr of Mouth.Dx 3\05. Surg.4\05.T3NOMO.IMRTx30. Recur Dx 1\06.Surg 2\06. Chemo: 4 Cycles of Carbo\Taxol:on Erbitux for 7 mo. Lost our battle 2-23-07- But not the will to fight this disease

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Amy's right, most of us were train wrecks at 4 weeks, physically, spiritually and emotionally.
Don't be too hard on Steve though - most of us don't want to remember the worst days of our lives.

The general rule is one month of recovery for each week of treatment.


Gary Allsebrook
***********************************
Dx 11/22/02, SCC, 6 x 3 cm Polypoid tumor, rt tonsil, Stage III/IVA, T3N0M0 G1/2
Tx 1/28/03 - 3/19/03, Cisplatin ct x2, IMRT, bilateral, with boost, x35(69.96Gy)
________________________________________________________
"You are a mist that appears for a little while and then vanishes" (James 4:14 NIV)
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I fully agree with Amy. I think there is no place for "tough love"...after all, it's not like she is misbehaving.
Gary, thanks for the reminder of one month of recovery for each week of treatment. Would you happen to know how to assess that for brachetherapy? I think my mom is going to get 4+ wks of radiation in 3.5 days.
Amy B--
you are doing a wonderful job, no matter how you may not think so at times. Being in a reverse position, caring for mother when you are the child, is hard. It's confusing at times-how much can we push? how do we define the lines for what is acceptable? My mom is my best friend too. Seeing her broken, well, it hurts. I think we both need to focus on the person we really know them to be. Somewhere deep inside this person we are currently looking at is our mothers. Believe in her, even when she can't. I think that helps my mom most.


Donna
CG to Mom, dx 4/25/07 with tongue cancer,T3N0,tx began 7/6/07, 31 tx's of IMRT, 8 cycles of Erbitux. Brachytherapy, surgery, left neck dissection and temp trach placed all on 9/17/07, trach removed 10/17/07. ORN of jaw, late effect of radiation symptoms. **lost my beautiful mother on 5/5/11.
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Amy B,

I don't think anyone wants to feel as lousy or dependent as your mom does right now. I was surprised that things got so much worse for my husband post-treatment...even though I had been forewarned. I do remember the day when he felt he turned a corner and then things slowly started to improve.

Prior to turning the corner, I could not get him to go outside...even to walk to the end of the driveway. So, good for your mom that she is taking a short walk daily. And, good for you for encouraging her.

I asked our RO how long before Dan would feel better, have energy, be able to speak clearly, be able to drive, be able to work again...the answers were all the same..."weeks to months because everyone is different".

One thing that you might check on is her hydration...if she is still throwing up she might need some extra IV hydration...that made a world of difference for Dan.

And, is your mom taking anything to help thin that awful mucous? That, too, can help.

I wish you and your mom the best.


Margaret
----------
C/G: Husband, 48 (at time of dx)
Dx 5/18/07 SCC, BOT, lymph node involvement. T1N2BM0. (Stage 4a, G2/3)
Tx 6/18 - 8/3/07, IMRT x 33 Cisplatin x3 (stopped after 1st dose due to hearing issues). Weekly Erbitux started 6/27/07 completed 8/6/07.
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