Jon,
I would talk with your team to see what they think about needing the Peg and how long you will be able to work. It seems they use the Peg less often in the Asian countries than we do here. If you are going to try it without the Peg, you will have to be very determined to get 48oz water down daily and 5 or 6 cans of whatever is availble as nutrition. Do you know what is available and how many calories each can has? You most likely will not be able to eat real food after the first couple of weeks so whether you drink it or use the Peg, you will be on a high protein drink for at least four weeks and maybe longer.

As to working, how much talking do you have to do? Discuss this also with your medical team. Everyone has different reactions to this treatment. They are a very few that get through without a Peg and can work, but it's not a lot of us. Considering its location, you may lose your voice for a few weeks. Your medical team should have the best idea of how well you will do. I hope you are one of the lucky ones.

Glad your brother is able to help you financially. That is one worry down and now you can get on with your treatment. Let us know what the treatment plan is when you get it.

Take care,
Eileen

Jon,

Next to Jim and Brian, lol, I am probably as stubborn a person as you will talk to. Now as I said I didn't get the PEG and believe me it was tough to swallow so I didn't get the daily calories or water I needed. So days would go by and I would grow weaker and become dehydrated which led to ER visits and unbelievable nausea making it even more difficult to get nourishment even if I swallowed so kinda like a snowball it just got worse and worse. I really doubt you will be able to teach either way you go. Not many of us are able to.

Jon

I was just dumb and did not get the PEG the first time I had cancer. However, I did force enough calories down each and every day by sipping Ensure, then rinsing with seltzer water. I never got dehydrated, never had to go to the ER, never needed any treatment by the hospital for anything. I kept full swallowing ability something I worried about if I got the Peg. It have been easier with the PEG though based on my experience this second time with cancer.
As to work, I was fortunate that I could work "virtually" through a secure encrypted server from home through my TX. Plus I had a Blackberry and speaker phone for the meetings which were mostly phone conferences anyway since they were nationwide. When I actually had to show up at the workplace after TX, it was too brutal and I retired early,
Best wishes and good luck
charm

Wow now I know how to get a response, just speak about something controversial, such as a completely free national Health Service, for genuine cases, with the sick and the non workers protected, as in Canada and Europe and all the rest paying for it, giving a small amount from their income, the more you earn the more you pay, as in the rest of the world, Including CUBA.

If you look at how much the American tax payers puts towards the health plans now and then look at what it would cost, if the majority was paying the minimum amount, according to what you can afford, you would have the best system in the world just look how the others manage it, then make yours better, in my humble opinion;)

So if you need a minimum of 3 pints of water a day how often do you drink it so as not to drown yourself?

How much of the nutrition drink is it best to take how many calories do I need to sustain a very good amount to live a good healthy life.

As I am a teacher and will be allowed off in the afternoons to take this treatment I will be expected to teach and talk will it become Impossible at all do you think.

Is Ensure or Carnation VHC Breakfast, nourishing drinks, the best, what�s the best for the most calories, how many do I need a day., at the most. Where would I get seltzer water, is it the same Alca Selzer aspirin drink.

To tell you the truth, I don�t really want a PEG unless I have to, as I�m totally terrified of being put under with an anesthetic,as my best friend died, who seems quite healthy with one. Do they give you a general for this or can it be done with a local.

If I was forced to have a PEG how much drink or nourishments do you take by the hour or when do you drink and eat with it.

Jon,

If our health system or any welfare system we pay for was ONLY for the people that TRULY deserved our help then I'm not against it in principal. Problem is at least here in the US that our current welfare systems take care of millions and millions of people that are able to work and should be working but choose to let THE SYSTEM care for them and their babies while their babies' daddies, usually multiple, get off scott free. Oh and the baby daddies usually sell drugs and avoid paying taxes altogether also. These same people seem to always have money for cars, cell phones, nails, etc while we, the hard working taxpayers, pay for their food, rent, health care, education and even clothing.

Anyway on to your real questions:

Re the water: I figured out that I needed to drink 6 cans of VHC and 6 glasses of water a day. I then divided those up into my new normal waking hours and figured I had to drink at least 1 can or glass every hour. When I felt up to it I would drink 2 to get ahead but often I would drink something and then toss it right back up. Hurt like hell going down and even worse coming right back up. Bear in mind that the worst of my Tx was from about the 5th week in to the 3rd week post Tx with the worst being the weeks POST Tx.

Re calories: I would shoot for 3000 per day and yes any of the VHC types are nutritionally balanced and perfect to sustain you through your Tx and recovery. I drank the VHC for over a year past my Tx.

I hope you are one of the ones that can work during Tx. I had full intentions to do so but I was out of it for about 2 months and even then had to slowly return to a full day's work.

Hi Jon,

I have been following your thread .

My husband had the PEG tube put in just before radiation treatment. He was resistent to it at first but is very glad he did it. From the fourth week of Tx and then for many months afterward that was the ONLY way he could get his nutrition. It is different for everyone. One of the radiation oncs told us that once you begin Tx, it is optimal to finish it without any breaks. She explained that if my husband started to lose weight, the mask would not fit and then he'd eventually have to get the PEG in the middle of Tx anyway.

He has maintained his swallowing by eating by mouth as well, but he just can't get all his nutritional requirements by mouth alone. He mouth and jaw become tired and his mouth still gets very sore.

When you are healing, you need to take in many more calories than you normally do. Your body requires more for tissue repair and to fight infection.

BTW, my husband still has the PEG almost 2 years out. No one can see it. He supplements 1 to 2 meals a day with it. Since the rad Tx, unfortunately, he has had numerous infections. This PEG has been a lifesaver for him.

He is getting ready to have his jaw rebuilt in a big procedure in November. The Plastic Surgeon was happy to hear that he still had his PEG as he will need it.

Clark wanted to remove the Peg beginning of last June. But when he stopped using it, he lost more weight. That scared him.

I wish you well in your treatment. You might ask your docs what the back up plan will be if you do not have the PEG and you have some feeding issues in the middle of Tx.

As for energy levels, Clark was wiped out most days during Tx and took long naps. He still gets very tired at the end of the day.

All the best--
Anita

you dont need and anaesthetic to have a PEG fitted.Rob had his done under sedtaion and he didnt feel a thing.

Jon

Ditto on DavidCPA's comments. Seltzer water is just plain water with carbon dioxide, H20 plus CO2. It has nothing to do with Alkaseltzer. It is similar to tonic water but without the quinine.
My peg was put in with just some percocet and zero anesthesia, I have not heard of anyone who goes under for just a PEG, so Cookey (Liz) sounds exactly right to me,
Charm

Jon,

If you have plans to have a mediport put in, please consider having the PEG put in as well during the same surgery. No harm done if you don't need it, but chances are about week three you will start having pain that is very tough and eating will become a chore. Most people here required major pain medications such as morphine and fentanyl during the last couple of weeks of treatment and the first few afterwards.

Getting the PEG tube as an afterthought will be harder as your body is depleted from the chemo/radiation treatments so one more assault will be very hard. You can work with both the PEG tube and the mediport and no one will be the wiser.

Wishing you luck slugging thru all these decisions...when we tell you what we think, we also know that nothing about this is easy.

Deb

Jon, I would strongly recommend that you consider the peg, you only need light sedation to put it in, it takes maybe 5".
It's small so you can't even notice it. As the others have said you need to get lots of calories, fluids, and nutrients in order to stay healthy through treatment and to heal. You will be healthier and recover quicker if you are in good shape nutritionally. Your throat and swallowing will be affected and it will be extremely difficult to eat and drink enough . My husband didn't want one and thought he could tough it out, by week three he was a hurting puppy and wgt was starting to plummet so he got one, but not willingly. You will need it after treatment is over as well, The weeks after treatment seemed to be the toughest.

Just be prepared that you probably won't be able to work every day towards the end and even after treatment, this is grueling treatment and you will feel like hell. If you're teaching you will be exposed to all those kids with all kinds of nasty bugs, (not sure if you have the H1N1 over there) but you need to limit your exposure since you will be compromised.

Good luck, start fattening up now. you'll get through it