I could really use some advice. My husband is being treated for tonsil cancer with radiation and cisplatin. Chemo was two weeks ago, and he has just completed his second week of radiation. During this time, he has maybe had two days that he consumed even close to a normal amount of calories. He does not want a peg, but he sure seems headed that way. Yesterday, he had a Carnation instant breakfast, half a can of soup, and maybe two bites of other food. He's had some nausea, but mostly just a full feeling or else everything tastes like goopy sand. I've been trying to fix every kind of food he mentions he might like, but he takes two bites and can't eat anymore. He just gets mad if I try to encourage him, but I'm so afraid he's going to end up in the hospital or impair his recovery. Does anyone have any advice on how I can stimulate his appetite or how I can encourage him to eat without making him mad? What has worked for you?

I am sorry he is having problems already. Food and water are not optional here. Its required. Eating will become much more difficult. As a caregiver its your job to do your best to gel calories and water in him. 2500 cals and 48 oz of water is safe zone, more is better. At two weeks, taste is all but gone. He will get over it as we all have. Have lots of Ensure, Boost around and keep pushing it on him. He must swallow as long as you can into treatment. Try diferent techniques, begging, pleading, yelling what ever it takes. As for the peg. Fully discuss this with the RO now. It takes a week or so to get. Have every thing in place incase he needs it. Most of us do.

Good luck and keep us posted. More will chime in and offer suggestions.

Should entertain PEG although that is not so simple at this point. Hockey Dad gave you some great advice and to reiterate calories and hydration are not optional. I am sure Christine will respond and she is very passionate about this subject. Ditto on Ensure or Boost.

If he becomes to dry they may postpone Radiation. I am sure he wants this to be over as soon as it can be. Maybe this can be a little motivation to drink and eat.

Like Hockeydad mentioned you have to do whatever it takes. And please don't take this in the wrong way. But have you tried balling your eyes out the next time he starts to push food that you lovingly prepared for his good health.

When I got to the point where it was painful and no taste. I did have my sence of smell and I would smell my food for a little while. And while eating I tried breathing in while food was in my mouth.(I could do this but it might not be possible for him) This would give me the illusion of slight taste. And taking pain meds about 20 minutes before din. din. made it easier to eat.

Best of luck lotsacats.....Shawn U.

This SO brings back memories of my son and what a difficult time he had with eating and drinking. It is really important to get the right amount of calories and water. If he gets dehydrated that could get really serious. My son had the same experience as Shawn's above, He found he could the sensation of taste by smelling the food. He didn't want the PEG either and there's a lot of information on both sides of the issue if you do a search in the search box upper left. Maybe if you print out the Peg info from posters comments, and let your husband see them, he feel more in control of whether he wants to consider a PEG or tough it out with getting the proper nutrition and hydration. After pleading with my son and doing everything I could to try different foods and only having him get angry with me, I finally followed the advice of someone who told me to "Put my nurse from hell hat on". So I got my courage up and in my most threatening voice I told him that if he didn't start eating right away, I would call my daughter (a policy officer with a gun) to come over and we would both get him into the car and take him to the hospital for a peg and some tube feeding! And that's what did it for him! He's been a cancer-free survivor for 7+ years! Does your husband use the Magic Mouthwash that dulls the mouth pain for a little bit so he can get some food down? That did help my son and a lot of people here. Sometimes you have to try a lot of things before you find something that works. Reactions to what works can change from day to day.

It's mult-factor at this point, with the pain, swelling, lack of saliva, lack of taste, mucocitis, swallowing ability, thrush and other bacterial, viral infections, lack of appetite, energy, and psychological, etc, so it's not one thing that is going to solve all the problems to make one want to or able to eat, plus it takes time. If you try to deal with each one, then maybe eating will improve.

As far as increasing appetite there are presciption meds, and OTC products you can ask the doctor about, foods, like marinol, megace, corticosteroids, steroids, caffeine, wine, sugar, fat, oils, sugar and oil are in most snacks, so you don't stop eating them. Even seeing food can increase appetite, and watching those cooking shows may do it, looking at cooking magazines. Smelling food, but sometimes some may have learned smell aversions from treatment. Some go to a buffet to sample foods to see what is tolerable, tasteful or not instead of eating time and money cooking what one may not eat. There are many other things involved.

Good luck.

As a caregiver there are limits as to what we can do. Kevin got mad at me too and there were days that he would not eat, but he did realize that he was beginning to lose weight like crazy so he worked on finding things that worked. He got a peg, but hated it and, after trying it a couple times, refused.
If your husband doesn't get the mandatory intake, he will most likely end up in the hospital and that may be what it takes for him to come to his senses. They are grown men...we can only do so much for them. Dragging their butts to the hospital is one!
Good luck,
Kathy

Welcome to OCF! Please check your messages as I have sent you a private message (PM). Its important that you add a signature so we can help you easier. Full instructions are included in the link on the PM I sent. As a caregiver you have a difficult job. Please dont forget to take some time for yourself too. This can be especially important as the treatments go on and it becomes more difficult.

As an adult, your husband must help to assume some responsibility for his care. I suggest you print out a bunch of the responses and show them to him. If he is the type that wont bother reading them then you can "accidentally" leave them lying somewhere you know he will find them and pick it up to read. Make sure its someplace where he will be able to read the posts in private so he wont feel like you are telling him what to do. This has worked quite well for many of the 'stubborn' ones.

Every single day your husband needs to take in a minimum of 2500 calories and 48 oz of water. If he chooses to cut corners and skimp eventually it will catch up to him. He may think he knows best and can do what he wants with his nutrition but he is WRONG! This is a sure way to get a fast track admittance into the hospital for malnutrition and/or dehydration. Im sorry to be so blunt but this is something that cant be fooled around with. Ive spent many a night hospitalized because I was too lazy to set up my feeding pump, I would just stay in bad and sleep. Ive seen many stubborn patients come thru here with their caregiver working so hard to help them but the patient fights them every step of the way. I hope you are not in that situation and your husband will realize its his life that is on the line and he must begin to step up and work at what he can control which is his intake.

Some caregivers line up all the water bottle the patient needs to drink per day on the counter. That works with ensure or boost too. This helps the patient to keep track of their intake and they can see progress as the day goes by to get rid of all the bottles before its bedtime.

Hope tomorrow is a better day

Best wishes!!!

Many, many thanks for the great suggestions; I'm going to try as many as I need to keep him moving toward recovery and to keep him from having to go to the hospital. Something will work on him eventually. At least he is very good at staying hydrated.

He absolutely hates the Ensure and Boost, but I'll try to get him to try it again now that his taste has further diminished.

Thanks Again!

Hi, lotsacats

There are a couple of problems with the bottled drinks - the flavor and the consistency: they are emulsified so that they do not separate on the shelf, and have the appropriate consistency of latex paint.

The solution my husband and I worked out was that he would force do one of the high protein drinks at work (I would call and remind him to do so), but I would make him a breakfast and dinner shake. As he lost the taste sensations it wasn't a case of making things taste good, it was a question of making them less dreadful. We did this with a combination of a packet of Carnation Instant Breakfast, milk (I rotated cow's milk, soy and almond just for the variety), protein powder. Other ingredients were whey powder, ice cream fruit (peaches were the mildest for him), baby oatmeal and rice cereal. And Benefiber!!! Even though nausea is your husband's major issue now, the question is still finding the most tolerable nutrition, timing, location to eat, etc.

The above was not perfectly balanced nutritionally (talk to a dietician if you are able), but it did get him through therapy without drama.

A couple of other tips:

Constipation (caused by change of diet, pain meds) doesn't do a thing for your appetite, so make sure that is attended to.

As the radiation caused more pain, my husband would drink his shake standing up at the sink as it was easier for him to swallow. I wonder if this would help with the nausea, too?

Be careful with any cooking odors. If he is having nausea issues, cooking up a big pot of corned beef and cabbage may not be the best plan. This may or may not bother him, but a friend did mention this was something to watch out for.

Best of luck to you both,
Maria

PS: My husband still has a breakfast shake with milk, whey power, fruit and cooked oatmeal. When he does one with apples, he adds cinnamon and cloves. Really tasty.