Mrs W, Im so sorry to read about your husbands struggles with his treatments. I also started to struggle about 3 weeks into it. Gosh, how I remember those horrible days of nausea, weakness, pain and just feeling horrible. My downfall was I would sleep 20 hours a day and not always get a proper feeding in. Dont worry!!! I have many ideas that will help your husband get thru this.
Yes, give him antinausea meds around the clock. Once he gets behind on them its nearly impossible to get ahead of the nausea. Just in case, there are anti-nausea suppositories if necessary. Also I found zofran to work the best for me to stop the nausea. Pay careful attention to his nausea as it quickly turns into a viscous cycle of being too sick to eat or drink but he still must consume enough to take in daily minimums of water and calories. I found the feeding pump to be very helpful. It can run slowly overnight (maybe start 60 ml per hour which is only 2 oz). After a couple days of tolerating this overnight feedings, bump up the speed to 80ml an hour and after a couple more days 120ml per hour. Even a rate of 120 isnt that much only 4 oz per hour but it sure is better than trying the push or gravity methods. Usually slower feedings with the pump are much easier to tolerate. Just make sure your husband is propped up on at least 2 pillows, if you can raise the head of the bead about 6 inches. I used several books at the head of my bed between the mattress and boxspring. Its very important your husband does not lay down for the feedings as this can cause even more problems of aspiration. he should also stay still for at least a half hour after doing a feeding. I would encourage your husband to either stay in bed propped up or in a recliner to do the feedings and to use the pump to take in at least 5 cans a day. Pay attention to how many calories are in each can. I supplimented my prescription formula with Boost Very High Calorie. It has around 530 (sorry I cant remember the exact number) calories per can. Its also a bit thick so I would use 2 cans of that with adding about another 1/2 can each of water then another can of regular formula with some water. For patients who are struggling with their intake they may need to run the pump nearly around the clock to take in enough calories.
Its imperative for your husband take in at the very least 2500 calories daily. If you can get him to take in more like 3500 or even 4000 calories daily this will help to stop his weight loss. Ask your husbands doc to give you an open prescription to get extra hydration in the chemo lab at least 4 times a week. I know your husband will feel much better after getting a couple bags of fluid. If you can get him to do this every other day it will greatly help with his fluid intake and he will feel so much better. Remember the cans of formula count towards the water minimum of 48-64 oz daily. With nausea unfortunately what comes out must replaced and thats not always easy to do especially when the patient is very ill.
When a patient begins to drop weight that means they are not taking in enough calories. Even overweight OC patients are encouraged to not lose anything. When losing weight quickly, its not just weight its muscle too. This can become another serious issue called cachexia (see link below).
When cooking for your husband, avoid spices (even salt), anything that takes too long to chew and things that are thick like peanut butter. If he wants peanut butter try putting it in milkshakes to add calories and protein. The following list should help you to find things your husband can still eat easily like canned peaches (these will slide right down) or cream soups (helps with sensitive mouth sores). I also enjoyed yoo-hoo and chocolate milk during rads and recovery plus the extra calories sure didnt hurt.
List of Easy to Eat Foods Your husbands's physician can also prescription magic mouthwash (MM) to help numb his mouth so he can try to eat iwthout so much discomfort. I used MM made of lidocain, malox and benedryl. It was swish in my mouth for about 30 seconds then spit it out and eat. There are some variations of the MM, some patients have had theirs include nystatin (works on thrush) too.
Be aware of any pain your husband has. Its not at all helpful to the patient to be in pain, it only makes everything much more difficult for them. There are many strong prescription pain medications that come in liquid form which would be much easier for your husband than the pill form. Of course you must ask specifically for things in liquid form.
Here is a recipe for something I used to make and drink when I went thru treatments. The shake has anywhere from 1500-2200 calories depending on how its made. The list of easy to eat foods might help too, they mostly have a smoother texture and arent spicy which should be easier to tolerate. If your husband is ever eating and he feels like the spices in his food have set his mouth on fire, milk will instantly neutralize his burning mouth. I also found room temperature foods were easier for me to eat or slightly cool. Anything hot bothered my mouth and hurt like heck.
(All measurements are estimates)
Giant High Calorie Choc-Peanut Butter Milkshake3 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.
Of course you will want your husband to have the very best nutrition he can while he is going thru treatments and recovery. However, when a patient begins to struggle it becomes more about how to get the daily minimum calories and water in than a perfectly balanced diet.
One other thing to understand, rads is cumulative and will get more difficult as your husband continues thru treatments. This is why I stress the importance of getting ahead of this immediately. Every single day he MUST take in at least 2500 calories and 48-64 oz of water. As I mentioned earlier in the post, try your best to push him to get 3500 or even 4000 calories in per day to help him to bounce back. His daily intake has a direct impact on how well your husband will feel. Im certain if you can fix his intake thru the anti-nausea meds around the clock and a good 3500 calories with 50+ oz of water in 2 or 3 days he will feel much better and more like himself. Its so important to get him to this point so he doesnt get discouraged and want to quit. I tried to quit during about the last 10 rad treatments but my son and nurses wouldnt allow it. Im concerned that the last week of rads and first 2 or 3 weeks after it ends are the most difficult. By getting him back on track right away he will be well prepared to handle the worst weeks that are coming up.
I know all of this is not easy on either of you. Dont forget to take good care of yourself and take a break sometimes even if its only a walk around the block to clear your head. You have alot going on and so much on your shoulders. We have been there and understand. Its ok to vent or to lean on us, we will do our very best to get you both thru this.
Hang in there and please stop by frequently. Best wishes!!!
Cachexia, losing muscle OCF main site --- TREATMENT OCF Main Site --- Complications of Treatment 
