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#197365 - 10/09/18 09:09 PM G-tube and aspiration  
Joined: Jan 2003
Posts: 108
WZ Offline
Senior Member (100+ posts)
WZ  Offline
Senior Member (100+ posts)

Joined: Jan 2003
Posts: 108
Kansas
I have a couple of question about aspiration and G-tube.

For many years, I have been coughing a lot when I drink liquid, doctor said there is silent aspiration and it will cause aspiration pneumonia. I have not put G-tube yet but. my coughing gets worse lately and I am think to put in the G-tube. My question is that if one gets aspiration pneumonia, will he or she definitely have fever? I do not remember I ever got pneumonia or high fever, but I do not want to take chance any more. If you get G-tube inserted, do you still eat by mouth occasionally? (depending on the food and coughing situation)



Thank


WZ | Stage 4, Tonsillar Cancer Aug, 2002
#197366 - 10/09/18 11:43 PM Re: G-tube and aspiration [Re: WZ]  
Joined: Jul 2012
Posts: 3,117
PaulB Offline
Patient Advocate (old timer, 2000 posts)
PaulB  Offline
Patient Advocate (old timer, 2000 posts)

Joined: Jul 2012
Posts: 3,117
NYC
WZ,

You still can have aspirational pneumonia from saliva or even acid reflux, even with a feeding tube, but I’m not sure of the percentage rates. When I was going through “swallow boot camp” I was told there was new information about those with head and neck cancer and aspiration recovering from pneumonia better than others in various medical populations, but I never read a medical paper on it.

Fever, although it can accompany infection, it is not always the case even with that or aspirational pneumonia, speaking from experience.

Does you doctors agree on a feeding tube? Maybe swallow therapy with or without a feeding tube will help?

With a feeding tube you still can eat by mouth. I had my second tube about 5 years as I was afraid to do without it through my various future treatments. After it broke, I had the button type taken out by endoscopy through my mouth, which was not fun. My first tube I was able to be yanked out, so there is a difference in types, I think balloon and plug, but my memory is fading.

Good luck with everything!


10/09 T1N2bM0 Tonsil
11/09 Taxotere Cisplation 5-FU 6 Months Hosp
01/11 35 IMRT 70Gy 7 Weeks
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 weeks Taxotere Erbitux
10/13 SND
10/13 TBO/Angiograph
10/13 RND Carotid Removed IORT 10Gy PNI
12/13 25 Proton Therapy 50Gy 6 weeks Carboplatin
11/14 All Teeth Extract 30 HBO
03/15 Sequestromy Buccal Flap ORN
09/16 Mandibulectomy Fibular Flap Sternotomy
04/17 Regraft hypergranulation Donor Site
06/17 Heart Attack Stent






#197367 - 10/10/18 12:49 PM Re: G-tube and aspiration [Re: WZ]  
Joined: Oct 2012
Posts: 1,012
gmcraft Offline
"OCF Canuck"
gmcraft  Offline
"OCF Canuck"
Patient Advocate (1000+ posts)

Joined: Oct 2012
Posts: 1,012
Toronto, Canada
You need to watch out if hare getting silent aspiration. At least you’re coughing when liquids go down the wrong way. My husband didn’t feel a thing at all when he aspirated. The SLP at the hospital told us that just the amount of saliva going down the wron “will catch up with you over time.” Are you drinking thickened liquids? That should help a bit. Consult an SLP who specializes in swallowing problem if you should be taking in nectar/honey/pudding grade thickness.

The doctors can tell if you are suffering from silent aspiration by doing a culture of the phlegm you cough up. It will show if you have bacteria that’s not normally found inside the windpipe in your phlegm.

My husband never had a high fever on the occasions when he was hospitalized for aspiration pneumonia. He had chills and he threw up blood which ad the consistency of coffee grounds. He needed oxygen on a permanent basis after his first stint in the hospital. He was given a nasal tube for feeding while he was in hospital and the point was to not give him anything by mouth.

Silent aspiration is a very serious condition. I implore you to be really careful and to make sure your doctors are fully aware of your condition.


Gloria
She stood in the storm, and when the wind did not blow her way, she adjusted her sails... Elizabeth Edwards

Wife to John,dx 10/2012, BOT, HPV+, T3N2MO, RAD 70 gy,Cisplatinx2 , PEG in Dec 6, 2012, dx dvt in both legs after second chemo session, Apr 03/13 NED, July 2013 met to lungs, Phase 1 immunotherapy trial Jan 18/14 to July/14. Taxol/carboplatin July/14. Esophagus re-opened Oct 14. PEG out April 8, 2015. Phase 2 trial of Selinexor April to July 2015. At peace Jan 15, 2016.
#197369 - 10/10/18 05:51 PM Re: G-tube and aspiration [Re: WZ]  
Joined: Jan 2003
Posts: 108
WZ Offline
Senior Member (100+ posts)
WZ  Offline
Senior Member (100+ posts)

Joined: Jan 2003
Posts: 108
Kansas
PaulB, gmcraft

Thanks a lot for your advice. I will ask my ENT to prescribe another swallow test. I was warned to have G-tube installed soon after my treatment, it was almost 15 years ago, then the swallowing got better so I did not do that. In 2014 I was warned again after a swallowing test showed some silent aspiration, then I gradually stop eating solid food, just drink Fibersource, Isosource or Boost by mouth during the day and have noodles for dinner. Now, no matter how I adjust the consistency of the liquid and the way I drink them, it will cause coughing. Recently, the reluctance to eat (drink) has made me lost 20+ pounds, so I think it is time for G-tube.


WZ | Stage 4, Tonsillar Cancer Aug, 2002
#197370 - 10/10/18 07:37 PM Re: G-tube and aspiration [Re: WZ]  
Joined: Jul 2012
Posts: 3,117
PaulB Offline
Patient Advocate (old timer, 2000 posts)
PaulB  Offline
Patient Advocate (old timer, 2000 posts)

Joined: Jul 2012
Posts: 3,117
NYC
WZ,

The 20lbs is a signifigant weight drop! I agree to see your ENT for a swallow study, and your willingness for a peg tube being your swallowing is getting worse instead of better. I heard this can happen in some long term survivors. I’m 10 years out myself, and not without incident, but I congratulate you on 15 years, minus any current difficulty, and this you shall overcome too!

Best wishes


10/09 T1N2bM0 Tonsil
11/09 Taxotere Cisplation 5-FU 6 Months Hosp
01/11 35 IMRT 70Gy 7 Weeks
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 weeks Taxotere Erbitux
10/13 SND
10/13 TBO/Angiograph
10/13 RND Carotid Removed IORT 10Gy PNI
12/13 25 Proton Therapy 50Gy 6 weeks Carboplatin
11/14 All Teeth Extract 30 HBO
03/15 Sequestromy Buccal Flap ORN
09/16 Mandibulectomy Fibular Flap Sternotomy
04/17 Regraft hypergranulation Donor Site
06/17 Heart Attack Stent







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