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#184798 09-03-2014 08:26 AM
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My husband is 3 weeks out of treatment as of yesterday. He is getting nowhere. Still taking all nutrition and water through PEG. He is still hacking up copious amounts of thick mucous and his throat has actually gotten more sore in the last few days. Now, he is only taking oxycodone before bed to help with sleep. So, I'm thinking that he should still be on pain meds for the sore throat? I tried to push him this morning to try drinking some warm herbal tea to kind of get the goo to slide down the throat. I just keep thinking that he needs to get some of that mucous that is clinging to his throat to move. I'm at a loss as to how I can help him. He is so depressed and didn't react well to my prodding this morning. He insisted that he would choke and that his throat feels too tight and swollen and thick to get anything down there. Should I back off? I am trying to be sensitive to him and at the same time, push him a little to try the next step. Am I wrong? Since you all have gone through this, I am relying on your advice and feedback. I'm trying so hard to get this right. I just want to cry but I maintain a calm front because he certainly doesn't need me being emotional. Ugh. I have been reading and trying to see if he's behind in recovery. I know everyone is different. Please help me out here, Guys. We have an appt. with his RO next Thurs. I'm hoping that he makes a little progress before that visit.

Trying to help my guy,

Carol


Carol
Husband diagnosed SCC BoT 4a-June 4, 2014
Mets bilateral lymph nodes
HPV positive
Tx started June 23, 2014
Blood clot in cephalic vein of right arm after first chemo
2x Cisplatin (hopefully getting in 3rd)
35 IMRT (hopefully complete on Aug. 12)
third Cisplatin cancelled
Last day of treatment Aug. 12, 2014
PET scan Nov. 10-NED (some PT inflammation)

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Hi Carol. It sounds like you both are just about where my husband and I were at that time. My husband's gunky throat was at its worst for about 3 weeks after treatment ended, and then it started to improve. I also struggled with gentle prodding versus not wanting to push him too much. It was so hard to see him suffering so horribly and there was not much I could do to make it better. Just know that you are likely at the worst of it now, and he will get better!!! My husband was completely unable to take anything by mouth for a few weeks. The swelling should start going down soon. He will have to push himself at some point though to start swallowing. I'd continue with some intermittent, gentle suggestions. Again, know that this will get better. Your just being there is a tremendous support to him. Please keep in touch with us and let us know how it is going. Feel free to email me directly as well. Good luck, and you are doing great!!

Randi


Spouse/caregiver to my husband:
Age 48 @ diagnosis
HPV+ SCC Stage IV diagnosed 1/14
Primary site unknown
Met to neck lymph node; 2" tumor resected 2/13/14
Completed 7 Cisplatin weekly sessions and 35 daily IMRT sessions 5/6/14
PET scan clear 11/14
CT clear 10/15
CT clear 10/16
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Randi, I can't thank you enough for your reply. Just knowing that you understand what I'm struggling with at the moment is comforting. You really do understand! It means a lot. I know that swallowing is of utmost importance and gentle prodding is exactly what he needs. I have no idea what he feels like at this moment and I always try to keep that in mind. Thank you for your support. I just might take you up on that email, as well. I see from your signature that your husband is just a few months ahead of mine with the end of treatment. I'm so happy for the two of you. What an accomplishment, huh? My best to you both and thank you for your time.

Carol


Carol
Husband diagnosed SCC BoT 4a-June 4, 2014
Mets bilateral lymph nodes
HPV positive
Tx started June 23, 2014
Blood clot in cephalic vein of right arm after first chemo
2x Cisplatin (hopefully getting in 3rd)
35 IMRT (hopefully complete on Aug. 12)
third Cisplatin cancelled
Last day of treatment Aug. 12, 2014
PET scan Nov. 10-NED (some PT inflammation)

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Carol, Im so sorry your husband is having such a hard time! As a caregiver you have what feels like the weight of the world on your shoulders. It must be so difficult to watch someone you love struggle and trying to help but only managing to feel helpless to them. I just cant imagine how hard this is for you.

Your husband is right about where most of us were after only 3 weeks post rads. Recovery takes a LONG time, much longer than any of us would like. Its full of ups and downs with some setbacks thrown in here and there. Everything really will get better very soon. He is almost at the point that we call "crawling out of the tunnel". One day very soon he will wake up feeling slightly better than he did the day before. He will realize he has finally made some progress and then the healing will begin. Radiation is progressive and continues to work for weeks after finishing treatments.

The thick gunky mucous last only about a month before it overnight turns into the dry mouth phase. He can always go see his ENT or oncologist to get suctioned out. Ask your doc for a prescription for a portable suction machine so he can do it at home.

Rinsing with seltzer water, using a waterpik on its lowest setting and continuing to rinse with baking soda, salt and 16 oz of warm water all will help as well. Some members have found relief with gargling with seltzer water.

His intake still must be your main focus. Every single day he needs a minimum of 2500 calories and 48-64 oz of water. This needs to continue until he hits the one year post rads mark. His nutrition is what will heal him and get him back on his feet. If you can push him to take in more, even 3500 calories its not too much for this phase. The more he takes in the better he will feel.

Here is a recipe for something I used to make and drink when I went thru treatments. The shake has anywhere from 1200-2000 calories depending on how you make it. The list of foods might help too, they mostly have a smoother texture and arent spicy which should be easier to tolerate.

Easy to Eat Food List

(All measurements are estimates)

Giant High Calorie Choc-Peanut Butter Milkshake

3 or 4 cups chocolate ice cream (regular/full fat type)
2 tablespoons peanut butter (smooth type)
2 tablespoons chocolate syrup
1 or 2 cups whole milk (can substitute half and half to add even more calories)
1 scoop carnation instant breakfast
1 scoop high protein whey powder
(check with doc if this is ok)

Blend this extra long to make it very smooth and creamy so it goes down easier. If the shake is too thick, add more milk to thin it down to what works best for you.



Hang in there, things really will begin to improve very soon.


Christine
SCC 6/15/07 L chk & by L molar both Stag I, age44
2x cispltn-35 IMRT end 9/27/07
-65 lbs in 2 mo, no caregvr
Clear PET 1/08
4/4/08 recur L chk Stag I
surg 4/16/08 clr marg
215 HBO dives
3/09 teeth out, trismus
7/2/09 recur, Stg IV
8/24/09 trach, ND, mandiblctmy
3wks medicly inducd coma
2 mo xtended hospital stay, ICU & burn unit
PICC line IV antibx 8 mo
10/4/10, 2/14/11 reconst surg
OC 3x in 3 years
very happy to be alive smile
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Christine, thank you soooo much for all your encouragement and advice. You certainly have been there. You're rather incredible. I looked in his throat today and it appears his mucositis has worsened back there. His mouth is almost healed except for under his tongue. Because the rads continue to work for a couple of weeks post tx, is that possibly why his throat has gotten worse the past week?

He is so exhausted that I watched as he sat in his chair, watching TV. He started to cough up mucous and gagged. As he was spitting into his bucket, that poor man started nodding off! It was so sad and pathetic I had to go into the laundry room and have a good cry. Just breaks my heart. He will not lie down at night. He stays propped up on the couch because he says he chokes if he's not upright. You can imagine he gets very little sleep.

Alright, enough of my rant. Big girl pants are back on!

Thank you for ALL your help.

Carol



Carol
Husband diagnosed SCC BoT 4a-June 4, 2014
Mets bilateral lymph nodes
HPV positive
Tx started June 23, 2014
Blood clot in cephalic vein of right arm after first chemo
2x Cisplatin (hopefully getting in 3rd)
35 IMRT (hopefully complete on Aug. 12)
third Cisplatin cancelled
Last day of treatment Aug. 12, 2014
PET scan Nov. 10-NED (some PT inflammation)

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Carol its a tough time, 3 weeks post rads is about as bad as it gets. Every journey is slightly different, but it should start to improve soon. As Christine says it takes a long time. Sometimes it feels you're not getting any improvement at all. It takes months not days or weeks. Don't be demoralised by that, just hunker down for a long haul and accept that a slow recovery is entirely normal.

Keep the machine working and it will repair itself. Keep the nutrition and hydration up, manage the symptoms, particularly pain. Pain interferes with healing and sleep. Pain meds can interfere with bowel function so keep on top of constipation. Keep in regular contact with a good doctor to monitor and manage changes in symptoms. Often its good to go to the doctor with a bunch of symptoms and leave relieved to hear that everything is within expected norms.

The most important thing is nutrition. A lot of people think they can afford to lose a few pounds and they'll pick it back up later. It doesn't work that way. Keep the intake up the whole time, otherwise it will make the recovery even longer.

Lastly be kind to yourself Carol. It is very easy to blame yourself or be frustrated he is not eating or doing what he should. This is also entirely normal, just recognise you are doing your best and you are getting through it. Look back and you'll realise you've already done an amazing job to get to this point.


Cheers, Dave (OzMojo)
19Feb2014 Diagnosed T2N2bM0 P16+ve SCC Tonsil.
31Mar2014 2 Cisplatin, 70gy over 7 weeks (completed 16May2014)
11August2014 PET/CT clear.
17July2019 5 years NED.
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Hi Carol - It's been a while since I was Caregiver for my son - but I still remember very well how difficult those few weeks after Rad Tx ended. But as others have said, it will get better. It gets so frustrating when it doesn't look like the person you are trying to help doesn't seem to care about doing what he should. My son, also slept in a recliner and became so very depressed and all the time he was assuring me that he was taking his meds on time and drinking enough water when in fact he wasn't. What I did was make a chart which contained all the meds he was supposed to take and the times he was supposed to take them. Also on the chart was what he ate and notes about what happened. It had all the doctor's names, phone numbers and names of the nurses and assistants. That way when I had to call I could ask for a name and I could tell them what was going on and what time it occurred. I put the chart on my son's refrigerator so he could check it and make sure he did what he was supposed to do while I was gone. I usually went home at night, but sometimes I stayed overnight. I think having the chart to deal with helped him to feel more in control and take some of the responsibility for his care. It is really important to record everything that goes into or comes out of his body. Not everyone reacts the same to situations, sometimes you just have to keep trying different things until something works. It is soooo hard seeing someone you love go through the torture and after-effects of surviving. My son also did not react well to my well-meaning efforts to help. He couldn't raise his voice much because of the pain in his mouth and throat, but I knew he was attempting to yell at me when he told me I could not understand how bad it was and that it felt like sharp knives piercing his throat to try to swallow anything. I used to cry on the way home in my car or run to the bathroom until I could hold it together. Things will get better and maybe the two of you will even manage a smile or be able to laugh at a funny movie. You are an excellent caregiver, Carol - all the more reason for you to make sure and take care of You and do something nice for yourself. Ok, now go do it.


Anne-Marie
CG to son, Paul (age 33, non-smoker) SCC Stage 2, Surgery 9/21/06, 1/6 tongue Rt.side removed, +48 lymph nodes neck. IMRTx28 completed 12/19/06. CT scan 7/8/10 Cancer-free! ("spot" on lung from scar tissue related to Pneumonia.)



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Sleeping propped up is helpful with the thick gunk. Many of us have gone thru the same thing and slept in recliners or propped up on extra pillows.

You are correct, rads is still working so thats why it looks worse in your husbands mouth. Dont be afraid to take him back to the doctor if he is still struggling. Too often when a patient ends rads, they feel abandoned by their medical team. At the very least they can suction out the gunky mucous and at the least confirm everything really is ok.

Hang in there! Very soon your husband will begin to improve! Please dont forget to make some time for yourself thru all this too. You are right there every step of the way and going thru it too.


Christine
SCC 6/15/07 L chk & by L molar both Stag I, age44
2x cispltn-35 IMRT end 9/27/07
-65 lbs in 2 mo, no caregvr
Clear PET 1/08
4/4/08 recur L chk Stag I
surg 4/16/08 clr marg
215 HBO dives
3/09 teeth out, trismus
7/2/09 recur, Stg IV
8/24/09 trach, ND, mandiblctmy
3wks medicly inducd coma
2 mo xtended hospital stay, ICU & burn unit
PICC line IV antibx 8 mo
10/4/10, 2/14/11 reconst surg
OC 3x in 3 years
very happy to be alive smile
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Carol,

My Dad went through the same thing. We didn't know until a few weeks after radiation stopped that everything gets worse for about four weeks after treatment. Doctors weren't real helpful with information. This is a very difficult process for everyone (the patient and the loved ones). Dad was afraid of becoming addicted to pain meds so resisted taking them, but our GP doctor and nurse said so long as you take meds as prescribed it should be okay. The healing process is very long. My Dad got real depressed thinking it would never get better, and he still has some set backs. He is three months after treatment, sore throat and pain in mouth cleared up, but tastebuds aren't back yet. But everyone I talked with says they will come back. Things will get better but it does takes time. Of course your guy will get tired of hearing that, but both of you hang in there.
Robin


robin
My dad age 62 lymphnodes in left cheek removed (two cancerous) chemo/radiation ended May 31, 2014
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Thank you, all, very much for sharing your experiences and for your suggestions. We have had an extremely rough day. His throat and now his tongue are both getting worse. The mucositis is actually getting worse! I told him today that, effective immediately, he is back on pain meds every 6 hours, as directed. I know that the rads continue to work for a couple of weeks out from treatment, but is this normal? He will be 4 weeks out next Tues. I don't know why his RO told him that he should be noticing a difference in 2-3 weeks. Really?!! He told my hubby that he will definitely be feeling better by the time he sees him next. Well, that will be on Thurs. of next week. I really don't see that happening. If it weren't for all of you, I think I would be terrified that something was drastically wrong with him.

We are doing very well with his nutrition (PEG) and hydration. He's getting 3200-3500 cal. a day and he's been getting between 70-80 oz. of water. It's been very hot here and I don't want him getting dehydrated. He's gained 2 pounds since the end of treatment. Thank you for the reminder of really watching his calorie and water intake. I do push him on this.

Anyway, thank you all for your reassurance, above all. It really does help keep me sane and I read it to him, also. Your words have definitely helped ease his anxiety about not feeling any better, yet. You have also given both of us hope. You guys are really the best. Thanks for taking the time to read and offer your help. Wish I could give all of you a huge hug. smile

Take care, all,
Carol


Carol
Husband diagnosed SCC BoT 4a-June 4, 2014
Mets bilateral lymph nodes
HPV positive
Tx started June 23, 2014
Blood clot in cephalic vein of right arm after first chemo
2x Cisplatin (hopefully getting in 3rd)
35 IMRT (hopefully complete on Aug. 12)
third Cisplatin cancelled
Last day of treatment Aug. 12, 2014
PET scan Nov. 10-NED (some PT inflammation)

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Hi Carol,

Your concern comes through as does your uncertainty of it all. Be assured that what you describe is not unusual at all. 4-6 weeks post is a common timeframe when survivors feel the worst. It will improve soon.

Take comfort the weight is coming back on and the hydration is good as dehydration can hit very quickly and knock one down in a blink.

The mucous can be removed with a suction machine, ask about that next week. I never had it but read it does pass in a few weeks.

Things are going pretty well so hang in there, more improvements on the way shortly.


Don
Male, 57 - Great health except C
Dec '12
DX: BOT SCC T2N2bMx, Stage 4a, HPV+, multiple nodes
1 tooth out
Jan '13
2nd tooth out
Tumor Board -induction TPF (3 cycles), seq CRT
4-6/2013
CRT 70gr 2x35, weekly carbo150
ended 5/29,6/4
All the details, join at http://beatdown.cognacom.com
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Carol, it sounds like good news. Believe it or not. And the docs do have some idea from experience. The hard part is everyone is really different and if they see one thing, it may not pertain to everyone. The worst thing I heard over and over is, "I've heard that could happen" when they really know it happens often.

Even with thousands of members here, what you are seeing may not be the same as anyone or many experienced the same thing. That's what makes all of this so tough. Hang in there and I hope it gets better soon. Bless you and your husband.


SCC Stage IV, BOT, T2N2bM0
Cisplatin/5FU x 3, 40 days radiation
Diagnosis 07/21/03 tx completed 10/08/03
Post Radiation Lower Motor Neuron Syndrome 3/08.
Cervical Spinal Stenosis 01/11
Cervical Myelitis 09/12
Thoracic Paraplegia 10/12
Dysautonomia 11/12
Hospice care 09/12-01/13.
COPD 01/14
Intermittent CHF 6/15
Feeding tube NPO 03/16
VFI 12/2016
ORN 12/2017
Cardiac Event 06/2018
Bilateral VFI 01/2021
Thoracotomy Bilobectomy 01/2022
Bilateral VFI 05/2022
Total Laryngectomy 01/2023
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Carol,
When I read your post I think I could have written the exact same thing about my Dad. Even the doctor telling him he'd see improvement in 2 to 3 weeks. When we didn't see improvement and it actually got worse we questioned the doctor and the doctor kind of back tracked and said well it actually takes a few months for significant improvement. I know how hard this is for both of you but hang in there, don't give up, this will get better.
Robin


robin
My dad age 62 lymphnodes in left cheek removed (two cancerous) chemo/radiation ended May 31, 2014
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Hi, Carol
be sure to ask about thrush at the next appointment - if that is in the mix it will add the the misery - but it can be successfully treated.
I think that some of the misery after treatment is due the loss of an active lifestyle. We walked our old dog nearly every morning - and I think that little touch of normal activity helped him mentally and physically. Maybe a little walk up and down the block would help - we should be have nice weather next week.
Is your husband a football fan? Not sure if you're in Browns territory or not, but it should be an interesting game with the Steelers tomorrow. Maybe next week he would be up for watching a game with friends or family.
One other suggestion. My husband found that it was easier for him to swallow when he was standing. He would drink his Ensures or protein shakes standing at the sink so if he coughed it wouldn't be a mess. I would leave the room until he was done, because it upset me and that upset him.
Everyone is different - we all evolve coping strategies. There will be a light at the end of the tunnel (and not a train!).
Best wishes,
Maria


CG to husband - SCC Tonsil T1N2M0 HPV+ Never Smoker
First symptoms 7/2010, DX 12/2010
TX 40 IRMT (1.8 gy) + 10 Cetuximab
PET Scans 6/2011 + 3/2012 clear, 5 year physical exam clear; chest CT's clear of cancer. On thyroid pills. Life is good.
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Carol,
My mucus lasted until exactly 3 weeks post and my mucositis until 5 weeks post so he is in a similar range to where i was. But then suddenly it all starts to improve. I truly thought the mucus might kill me; was by far the worst sx for me. So just help him through and keep reminding him that there is a light at the end of the tunnel. It really DOES eventually go away. Also, I resisted narcotics at first but actually ramped them up during the mucus phase b/c the only thing I found to decrease it was percocet. Weird but it gave me some relief. Going on walks also helped me as I would be distracted at least temporarily. Good luck and I hope he feels better soon!


Laurie
42 yo
Pediatrician
No smoke, social drink, HPV neg
May 2013 - SCC Right lateral oral tongue - stage 1 (T1N0M0)
Partial hemiglossectomy and sentinel node bx NEG
NED 5/29/13
3/2014 - Cancer back (never gone) in one right sided cervical node
Modified neck dissection 3/2014, N1 with microscopic ECE,39 nodes neg
30 Rads and 2 cisplatin done June 13!
PET in 3-4 months but no clinical cancer and I'll take it!
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Thank you, all. I keep reminding myself that everyone is different and this does take time. Maria, I actually did think of thrush one evening because he started complaining of a new burning pain in his mouth. I peeked in and sure enough, white patches on his tongue and a spot on the back of his throat. The chemo onc. put him on Nystatin and Flucon. This was the first time he's had thrush. Hope it doesn't hang out in there!

Tomorrow is 4 weeks post tx and not much is changing. Although, his voice is suddenly getting stronger and starting to sound more like himself. The swallowing is still a no go and the mucous is not letting up.

Thanks again for all advice and experiences you all have shared. It makes me feel not so alone. You guys are really wonderful.

Carol


Carol
Husband diagnosed SCC BoT 4a-June 4, 2014
Mets bilateral lymph nodes
HPV positive
Tx started June 23, 2014
Blood clot in cephalic vein of right arm after first chemo
2x Cisplatin (hopefully getting in 3rd)
35 IMRT (hopefully complete on Aug. 12)
third Cisplatin cancelled
Last day of treatment Aug. 12, 2014
PET scan Nov. 10-NED (some PT inflammation)

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everhopeful64
I've been taking care of my mother since her Mandibulectomy (Jaw Bone Removal)On March 25,2014 . She is 6 months post surgery and 3 months Post RAD. My mother had the Peg but we kept pushing her to try an eat soft foods. She was afraid also of choking so The RAD Oncologist ordered a feeding test at the hospital. It seemed to ease her mind when she passed the test. She Constantly had a cup of crushed ice and a spoon that seemed to help a lot. She uses Biotene products for the dry mouth it helps a lot. It can be found at the pharmacy.


Sweetpe
Caregiver
RE:My Mother
Age 70
Non Smoker
SCC 3/4/2014 Left rear jaw
Mandiblctmy 3/25/2014
35RAD Completed on 06/03/2014
MRI 9/3/2014
25mm lobulated recurrence left mandible/floor of mouth carcinoma
9/23/14 Salvage Surgery
MET(s)
9/23/14 Salvage Surgery Not Successful
Chemo Recommended
1st Round of Cisplatin Chemo Started 10/20/14
Cisplatin stopped 11/20/14. Side affects to bad.
Chemo started again 1/22/15 Carbo/Docetaxel
Passed Away April 22,2015


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Carol, I just read your post today. How is your husband doing now?


Cheri-43 year old caregiver
51 year old husband with BOT Cancer, SCC, HPV16, enlarged lymph node at the neck, non-smoker, healthy and fit
ENT Appt 10-9-14
Biopsy 10-13-14, Results of Cancer 10-16-14, 1.8x2.2cm left side lymph node
1st Medical Oncologist appt 10-21-14, learned Stage 3 or early 4, T3N1Mx
1st Radiology Oncologist appt 10-30-14
PET Scan 10-27-14
1st weekly Erbitux chemo 11-12-14
PEG tube surgery 11-13-14
1st of 30 IMRT Radiation Treatments 66 gy 11-25-14
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