My sister was diagnosed with SCC on her jugular vein in November, 2010. She has finished all radiation but still has 3 chemo tx left. She has been hospitalized twice for dehydration and bloodwork a mess. We are ready to go to a cancer tx center but have no idea where to go. We are from NW TN so Nashville is probably the closest to us but we want to make sure we get a Head and Neck specialist. She has a PEG tube but just is not doing well with getting much down. Also she is a diabetic so we have to keep watching her sugars. I am pretty much her only support system. She is recently divorced and only has one son that is 25 yrs old who is paying her bills since she has been sick. I am just so lost as to what to do next. Any help with what to try in her PEG tube will also be helpful. Thanks

Lori - I'm so glad you found this site. There is a lot of information here and many knowledgeable people who can offer suggestions from experience. My son did not have a PEG tube but he did have surgery and Rad Tx. My son's surgery was in Knoxville at the University of TN Medical Center where a team of doctors treated him. His H & N surgeon was Dr. Eric Carlson and known for being aggressive in successfully treat his patients. You can find out about him at: http://www.utmedicalcenter.org/FindaDoc.asp?Doctor=285. My son is doing just great and it's been a little over 4 years, now. It is so important to get proper nutrition. A lot of people here have had experience with dehydration and I'm sure others with more PEG tube experience will be along to help with suggestions. There is a list of best cancer hospitals here if you want to check for something closer to Nashville:

http://www.oralcancerfoundation.org/resources/cancer_centers.htm
http://health.usnews.com/health/best-hospitals/cancer-hospital-rankings/

It's so good your sister has you and her son for support. It's really rough seeing someone you love going through treatment but there are better days ahead. You will get lots of support from everyone here, so keep checking back and let us know what's happening.

Lori, I only posted just today, but I want to let you know that you are a blessing to your sister. She is so lucky to have you.
God bless you and I will add your family to my prayer concerns.
Best,
Pat

Hi Lori. Sorry to hear about your sister. It sounds like she has been having a tough time of it. I would definitely head to a good cancer center - they have experience in dealing with the fall out from chemo and radiation and can likely help because they've see it all before.

There is also information available here to help with coping with radiation and chemo as many people have been through it before.

I wish I could tell you a good hospital in your neck of the woods but I'm in Canada... though I believe the list AnneMarie just posted is pretty extensive.

Take care, many prayers to you and your sister. It's not an easy road, but there are people here who can support you as you and your sister travel it.

Thank you so much for the links you gave me. We are praying that GOD will lead us to the right place and one of those in Nashville just may be it...We are hoping to go in the next few days, as I can already see her becoming slowly dehydrated and getting weaker just after being home from the hospital for two days. I appreciate your help so much....May GOD bless you..!!!

Lori Osteen

Thanks for the replies. We did find a head and neck specialist at Vanderbilt-Ingram in Nashville. My sister, Jeannie, and I are making arrangements to go in the next few days. Two more questions:

1) Can anybody give me more ideas to put in her PEG tube. She is a diabetic and we are using Glucerna, apple/cranberry juice, grape juice, and chicken broth. I just have to watch the sugar content.

2) Has anybody had any experience with the CCLR (Cancer Center Legal Resources) ? Jeannie's husband left her one month before she was diagnosed and has just today had divorce papers served on her. She has a few other legal problems and we had been told that this might be a good option.

Any help appreciated once again....God bless...!!!

Hi Lori - so sorry for all you and your sister are going through. Dehydration can take a person down very quickly so if she's having a lot of trouble now a few days before seeing an MD may be too long. Did a dietician visit your sister in the hospital? If so, he/she might be a good resource right now. Can you explain the trouble you're having with the tube feeding? Is she able to tolerate water? If so, the Glucerna (since it's made for diabetics) and just water might be better than juice and chicken stock.

If your sister has a feeding tube, doesnt she have a gastro doctor? Or how about a nutritionist? Ive always used prescription formulas. In addition to the prescription formulas Ive used Carnation very high calorie. I know the Carnation VHC wouldnt be a good fit for someone who is diabetic as its full of sugar.

To ensure your sister has enough calories, shoot for 2500 daily. As far as water goes, a minimum of 48 oz is what she should be getting every single day. If she isnt meeting those numbers then Im sure she isnt feeling that well. Whenever my calories and water feel short, he next day I felt lousy.

Sorry, but I have not heard CCLR mentioned before on OCF.

I am so grateful to read your sister has your love and support! Caregivers are amazing and we surely do appreciate them. I am very sorry to hear of what she is going through, and I hope you find a great center for her and will be thinking of her and you and her son and hoping for the best!

Thanks for all the answers above. I truly appreciate this forum and all of you who take the time to help those especially like me that are completely lost in this point of my life. May GOD bless each and every one of you...!!

Lori Brashier