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#185147 09-13-2014 01:59 PM
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No BM since the day before the first chemo, 5 days ago. Taking senna tablets as recommended, started Miralax yesterday, doubling up on both today. Is it time to call the on call doctor (its Saturday today), or wait another day?


Caregiver to husband with SCC BOT HPV+ T4N2cMO stage 4a
CT scan 7/23/14
Biopsy 8/7/14
PEG tube in 8/15/14, out 4/2015
35 rads, Cisplatin X 3 - finished 10/27/15
cancer free May 2018



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I think so. Have you tried a walk around the block? Sometimes that gets things 'moving'...
Hum, just read your blog about the tiredness and pudding cups and meds. No wonder he's backed up. I am still recommeding a walk - maybe a short block, though.
Maria

Last edited by Maria; 09-13-2014 03:15 PM.

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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In addition to Maria's recommendations, drink adequate fluids. Some foods have more water than others also.


10/09 T1N2bM0 Tonsil
11/09 Taxo Cisp 5-FU, 6 Months Hosp
01/11 35 IMRT 70Gy 7 Wks
06/11 30 HBO
08/11 RND PNI
06/12 SND PNI LVI
08/12 RND Pec Flap IORT 12 Gy
10/12 25 IMRT 50Gy 6 Wks Taxo Erbitux
10/13 SND
10/13 TBO/Angiograph
10/13 RND Carotid Remove IORT 10Gy PNI
12/13 25 Protons 50Gy 6 Wks Carbo
11/14 All Teeth Extract 30 HBO
03/15 Sequestromy Buccal Flap ORN
09/16 Mandibulectomy Fib Flap Sternotomy
04/17 Regraft hypergranulation Donor Site
06/17 Heart Attack Stent
02/19 Finally Cancer Free Took 10 yrs






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Since your husband has a feeding tube, try putting some pineapple juice or prune juice down it and add extra water. Pain meds can cause constipation so its important to push the water to daily take in a minimum of 48-64 oz. Keep giving the meds and you can also try adding fiber (like benefiber in his formula) too. If he still hasnt gone by tomorrow and feels lousy due to constipation, give the doc a call. There is always one on call, 24/7.


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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I dont know about Miralax. Does it push liquid through without being absorbed? I used Movicol, which does. Movicol was the only thing that worked. Perhaps ask the pharmacy if its a similar thing.

Do NOT add any fibre right now. Fibre is useful for maintaining regularity but right now, no.

Do not muck about with this. Right now everything is compacting up. Soon it will be compacted up to his stomach. He wont be able to medicate or hydrate orally, he will vomit everything that goes down. He'll be at the ER getting an xray to confirm that its all impacted, and need to be hydrated through a drip. The bowel will distend and be very distressing and uncomfortable for days.

They will stick him full of bowel prep to flush it out, which is basically the same as Movicol. Its a liquid that stays liquid from top to bottom, flushing everything in between.

It was 7 days before I went to the ER, followed by the worst 5 days of my life. Please don't let it get that bad. Talk to the pharmacist about whether Miralax will do the job. Senna certainly won't. All it does is soften the stool, it wont move it. You can talk to the doctors and nurses, but I doubt they will tell you much different. There is no magic pill once you get to hospital, it just needs to be flushed out. And it takes days to do that, very uncomfortable days.


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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Whew, finally had success after a dose of magnesium citrate followed 6 hours later by fleets enema. Drastic measures, and effective. I was worried after hearing about OzMojo's ER experience! He sees the medical oncologist in the morning and will talk about what to do going forward. Thanks to all for your thoughtful suggestions.

P.s. Movicol and miralax are both polyethylene glycol based laxatives.


Caregiver to husband with SCC BOT HPV+ T4N2cMO stage 4a
CT scan 7/23/14
Biopsy 8/7/14
PEG tube in 8/15/14, out 4/2015
35 rads, Cisplatin X 3 - finished 10/27/15
cancer free May 2018



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Oh thank goodness I've been regularly checking for your response. So glad to hear about your success. Great job!

Yeah I figured they'd be similar. I didn't understand how it worked and hated the taste of Movicol. I thought I could get away with upping the dose of Coloxyl and Senna. Big mistake.

Fleet enemas! Oh what a joyful memory that was. I'm wearing an adult nappy (diaper)and waddling down to the ER toilet after the fleet enema and I just know I'm not going to make it. At least there was no spillage!

The problem with enemas is they only work on the lower part of the bowel. If the blockage is further up, all an enema does is cause cramping and grief down the bottom.

The oncology nurses told me they use my story as a case study for new patients when explaining about constipation. No matter how bad the Movicol tastes, the alternative is much worse.

Painkillers tend to make the bowel go to sleep, and you'll need to keep that Miralax going for a while to keep things moving. Now that you're on top of it you can also look at prune juice or Benefiber, but go easy. A change at the top can take a while to get to the bottom so make those changes very gradual. Don't forget to keep the fluids up.


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.
Joined: Aug 2014
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Further update: his tummy is feeling much better as the laxatives continued to work today. Thankfully, no ER visit needed. MO was firm but kind about not letting it go so long again. Prescribed lactulose for future use. That would be in addition to the stool softener, senna tablets, benefiber and miralax!

Although he is feeling better now, he lost some ground when he went 24 hours with no nutrition because his digestive system was so backed up. I hope future first timers will heed the warning, not be so stubborn, and call the doctor early.


Caregiver to husband with SCC BOT HPV+ T4N2cMO stage 4a
CT scan 7/23/14
Biopsy 8/7/14
PEG tube in 8/15/14, out 4/2015
35 rads, Cisplatin X 3 - finished 10/27/15
cancer free May 2018



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I bet most, if not all, of us have been down that road! I'm glad to hear the problem is under control again.


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
Joined: Jul 2009
Posts: 1,406
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Indeed so, Uptown. Eventually I found that the only thing that worked was, yes, rubber gloves. Crude but effective.


David 2
SCC of occult origin 1/09 (age 55)| Stage III TXN1M0 | HPV 16+, non-smoker, moderate drinker | Modified radical neck dissection 3/09 | 31 days IMRT finished 6/09 | Hit 14 years all clear in 6/23 | Radiation Fibrosis Syndrome kicked in a few years after treatment and has been progressing since | Prostate cancer diagnosis 10/18

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