It has been a few weeks since I posted a message. I am the main caregiver for my husband, Don. He had heavy duty radiation(6/16-8/11/05) and neck disection (10/10/05) for a cancerous tumor on his left tonsil. Don has been on a feeding tube since 7/05. I have received some good suggestions from this website so I am back again for help. I wish there was something I could do for Don. The doctors don't know what to do.
My husband suffers from severe dysphagia diagnosed 12/05. He was undergoing ST and was making progress wish his swallowing exercises. On 1/25/06 a cat scan showed that the cancer had metastasized to his lungs, liver and bones. Don elected to have chemo. Chemo drugs: Taxotere and Cisplatin. He is also taking Neulasta, Aranesp and Zometa for his bones. A 4/5/06 cat scan showed that the tumoes in his lungs and liver and decreased but the bone lesions increased in number and size.

My husband has a high tolerance for pain. He is on Roxicet (28 mg) per day. He tried Duragesic but that only made him nauseous. His main concern is the pain he gets from coughing up the secretions. See below.

Don is having a MAJOR PROBLEM WITH SECRETIONS. His throat is raw and I hate to be so descriptive but he is coughing and throwing up blood. He is rinsing and gargling with Guaifenesin, Papaya juice mixed with club sode and for his sore throat gargling with children's tylenol. He is afraid to use Lidocaine since he complains that it is his throat that burns when he coughs or throws up.

Does anyone have any good suggestions on what I can do to relieve the pain in his throat.

Also, if I put Guaifenesin down his tube will that ease the secretions or make them worse?

Don would be better able to handle the chemo side effects if he did not have to deal with the secretions.

Any help you can offer would be appreciated.
Thank you all, Eileen

Eileen,I will be watching this thread anxiously because John is having the same problems. He had 2 major surgeries on his mouth less than a year apart plus radiation. The phlegm- ie secretions- are almost unmanageable. We have tried just about everything we have read here plus some other meds from his surgeon-to no avail. John starts chemo next week and I am so worried for him. He does have a PEG and at least we can get liquids down that way. What a battle this is. Have you tried a humidifier to keep the air moist, especially when he is sleeping? That might help some with the throat. Amy

Amy, we have had a cool mist humidifier since last year when Don first started radiation. Shortly,after chemo started, I purchased a personal steam enhaler and a vaporizer. The enhaler worked briefly and the steam affected my husband's previously radiated skin. My husband finally agreed to rinsing and gargling with lidocaine. I mix 1/2 tsp of lidocaine with 2 tsp of water. My husband tells me that the lidocaine helps ease the pain. As I said his throat is raw. If John's throat starts to bother him and he cannot swallow, ask your doctor about Lidocaine. No matter what, your husband needs to sip water as much as he can to keep his swallowing muscles strong. The lidocaine helps ease the pain. Amy, I do not know if your husband has a problem opening his mouth. I did have my husband do jaw exercises 3x a day and it really helped. He can open his mouth wide but unfortunately he has dysphagia.
You might want to access www.nidcr.nih.gov
National Institute of Dental and Craniofacial Research. My dentist told me about this site and I got loads of info. Eileen

I know everyone is different, but when we put the Guaifenesin into Eriks peg tube, he had thinner mucous. Our doctor gave us an Aloe Vera product that seemed to help with the thick mucous and sore throat issues. It was called Carrington Oral Wound Rinse. Just something to ask about.
I am praying for you.
Jennie

Jennie, how did the Carrington Oral Wound Rinse help with the secretions? Did it ease the secretions? thin the secretions? Did your husband use it as a rinse, did you put it down the tube? Is it an OTC product or do you need a prescription? I am pretty desperate to find something to alleviate Don's discomfit. He has decided he does not want to continue with chemo treatments since he suffers so much radiation recall. Any help you can offer is sincerely appreciated.
My thoughts and prayers are with you and your husband. Eileen

MY HUSBAND HAS TERRIBLE TROUBLE AS WELL. I DO AS PRESC. BY DOC 4 TSP. OF EXPECXTORANT EVERY FOUR HOURS, WITHOUT FAIL, THRU THE TUBE AND WE GOT A SUCTION MACHIN FOR HOME THAT HE COULDNT LIVE WITHOUT. ALSO, "ALKALOL " PRECRIBED BY DOCTOR 1 TSP WITH VERY WARM WATER RINSE AND SPIT. MY HUSBAND DOES IT ALL DAY LONG. GOOD LUCK ... KERRY

My husband cannot swallow. He had dry mouth right after radiation, then his secretions came back in abundance. Since he cannot swallow that is a problem. One of his team of doctors prescribed Transderm Patch, a prescription used for motion sickness. It has reduced the amount of secretions. We now have a problem of the
ability to open the jaws. No one cautioned him to exercise opening the jaws. Since he takes
everything by Gastric Tube, he has not been chewing for 2 years and the radiation after
effects are restricting jaw movements more and more. He was first diagnosed 06-1999.
Best Wishes.

I wish I had some answers. My brother had this as well. They gave him some type of saline solution to put down the trach - what a mess when he coughed it up! Blood sprayed everywhere from the tube - all over the walls, mirror, it was tough to clean up. He drank lidocaine like water - well, used it ALOT - but he, too, had a high pain tolerance and it did little good. He also had "plugs" that would take 2-4 days to pass. He would cough so hard he would become sick and had terrible headaches. He was always afraid the plug would stop up his trach and he wouldn't be able to breath. We tried the humidifer's too, in every room of the house. Finally they did put him on "breathing treatments" with a machine a few times a day. That helped, but I believe hospice set that up. I can't remember what it was called but can find out if you need me to.
I hope someone has an answer to this problem. Our loved ones are suffering enough without this to deal with too.
Tonya

Oh, seems like the doctors had his wife add a decongestant (liquid, over the counter) to his feeding tube. I can check. Still, none of this helped much.

My memories of those days are still vivid. I remember the crud in my sinuses, my mouth, my throat. The coughing and snorting is exhausting and makes everything else hurt too. The throat and mouth sores just add insult to injury. Vomitting was the worst and most painful. I never knew exactly where the blood was coming from - I always assumed it was from my throat.

The decongestants helped some, but the body builds a tolerance fairly quicly to them - requiring larger doses and/or doses more frequently. I had best luck by taking a lot of the Guaifenesin and trying to "stay ahead" of the accumulations.

But the best help I found was more hydration. I was losing fluids by vomitting, blowing my nose, coughing, and Olympic class diarrhea. The treatments dehydrate the whole body even more. The first step is to STOP the fluid loss. Get the drugs that stop the hurling and the squirts and take them. Being "tough" proves nothing and makes the overall condition worse.

Then, rehydrate. I finally starting pouring about 2 liters of water per day into my peg tube. That extra fluid helped me more than another single thing.

My wife learned how to hook up my pik line to an IV of fluid at home. The more fluid I got, the better I felt and my symptoms were much less dramatic. I could REALLY feel it when I didn't keep up.

Its a miserable time and must be endured. It does get better - I promise. Be strong. Tom