Hi,

I've just joined but have been reading the board for a while. My 61 y.o. father was diagnosed in early October with Stage IV SCC BOT, started 35x rad and 7x carboplatin (cisplatin judged too hard on his heart) early November. Found out late November that it is HPV+. He was set to finish treatment Tuesday (22 Dec), but was checked into the hospital Monday morning due to severe choking episodes to the point of passing out. He finished radiation Tuesday and is still in the hospital spitting every ten minutes. It is not getting better. The severe episodes (a couple a day) are very frightening especially because he is so weak (though very tough), and he really is afraid he will choke to death. He is spitting every 8-10 minutes 24/7.

It has been 5 days since he finished treatment and the docs are saying it will get worse for another week. He is getting very discouraged.

He is currently on:
-Guaifinesin
-Fentanyl patch (50)
-Fentanyl PCA (morphine didn't work)
-Antifungal for thrush (can't remember the name)
-Salagen (just added to increase saliva, some excess sweating)
-Glycopyrrolate (to dry mucus)
-Tylenol (to treat headache from thrush meds)
-Lidocaine/saline rinse (doesn't like b/c it numbs his mouth and then he chokes more)
-Senna and Miralax
-Zofran (for nausea)

-Just got a nebulizer
-Using PEG for Jevity 1.5 and meds
-IV for 4 liters fluids per day
-swishing saline on a regular basis

What we've tried:
-moisture mask
-suction tube (hurts too much)
-morphine PCA (too groggy, didn't cut pain)
-oxycodone
-dilotid
-magic mouthwash (benadryl in it made him too groggy)
-selexa (caused spasms)
-seltzer water / club soda (hurts too much)

What I've asked the docs to look into:
-Evoxac
-Salagen mouthwash

He is a trooper and is trying to push through. He has an extremely high pain tolerance and a keen understanding of the medications etc., as he is a surgeon. We had him propped up but his actually does better on his side. I would appreciate any suggestions or comments on the above combination of medicine, keeping in mind that his heart valve and clotting problems complicate things. Many thanks in advance.