Ryno --

Have you been to a swallowing therapist for evaluation? (Sometimes called swallowing/speech therapist). I personally think this should be a routine part of everyone's treatment after the end of radiation therapy. Unfortunately it is often not done. You obviously have a tremendous amount of healing still going on and someone needs to look and see what the status is. Radiation not only burns, it causes scarring, trismus, fibrosis of tendons and weakening of the muscles involved in swallowing. This in turn affects the ability of the epiglottis to "close off" and prevent stuff from going down your trachea (breathing tube). Since you have problems with this, you have swallowing issues which should be identified and addressed. Even though my husband was eating soft solids, when he had his swallowing test they found he was "silently" -- that is, unawares -- aspirating liquids which put him at risk for pneumonia.

A therapist will look at the results of your tests and prescribe exercises to strengthen your swallowing apparatus and tongue. These work, Barry has been doing his regularly since November and his swallowing function is pretty much normal now. They will also be able to see if you have ulcers or existing sores which have not healed. These may require some attention -- sometimes hyperbaric oxygen to aid healing, for example.

Ask your radiation oncologist or ENT for a referral for a swallowing test and also, ask for (nay, demand) more help with the issues of pain and nutrition/nausea. Are you on any pain medications? Any for nausea? No one should be put through treatment and then left to deal with pain and nutrition issues on their own. IMHO, this over-sight should be as much a part of your post-treatment monitoring as are regular CTscans etc.

Both our two local hospitals have swallowing therapists (and do tests) so this capability is not limited to the big CCCs.

As to the guafenesin syrup - if the dose is two teaspoonfuls -- dilute in 2 oz. of water and see if it burns. (Just put in mouth and swish around). No good, then dilute more -- to 4 oz. and see if you can handle it. It does help with the mucous...

If you vomit, be sure to rinse with salt/soda as the soda will counteract the impact of stomach acids on your mouth and throat -- which isn't helping healing. Will also help get that awful taste out of your mouth.

You should try an unflavored nutrient formula for the tube -- these are specifically made for tube-feeding and are better balanced nutritionally than Ensure or Boost, with less sugar. No flavor -- or very little -- which reduces the nausea-inducing artificial taste of the commercial drinks. Brands include Nutren and Jevity.

Gail Mac