My husband had a tumor the size of a lime and two small lymph nodes on both sides were affected; stage 4a. I am told his treatment is quite aggressive. His eight week treatment includes radiation every day and three treatments of cisplatin. Unfortunately, this is a living h--l for him. We have tried every med under the sun for nausea and none are working. We are using a pump for tube feeding to allow the formula to go in slower and in smaller amounts. As of today, he still can't tolerate any nourishment. The home health nurse said it might be due to constipation for three or more days, and the formula is not being absorbed so it is coming back up. Not a pleasant subject, but does anyone have an opinion on this? He will soon be hospitalized if this continues.
Thank you!!

As to your question, most pain medications are very constipating and it is usually necessary for patients to take stool softeners or even laxatives during treatment to stay regular. If he is nauseous on the feeding tube, try gravity feeding very slowly instead of the pump, and ensure that the formula you are using is room temperature, and that he is sitting upright while feeding and for at least an hour afterwards. I used to feed in a lounge chair in front of the TV for a couple of hours (then fall asleep for a couple more upright) routinely. Your doctors should be able to rotate him onto other anti nausea drugs, but this may have less to do with their effectiveness, and more with how he is being fed. Gravity feeding is less shocking to his stomach and generates nausea less.

Try diluting the formula and slowing it down. Start the pump out at 40. Add a can of water for every can or 2 of formula. I went thru 3 formulas before I found one I could tolerate. Talk with the hospitls dietitian. He may need another formula.

Welcome Caregiver, its good to see another Seattlite on the forums! Where I live in and am from Idaho, I lived in Seattle for 13 years and my wife is from there. I had all of my surgeries and my tumor board done at the UWMC.

I agree with Brian about the gravity feeding, it is less of a shock to the system. As far as nausea goes, WA has medical marijuana and I suggest talking to his drs about a script for it. No matter what the preconceived notions or bias the drug has associated with it, it is effective. It will help with pain, moods, sense of well-being, very effective w nausea and will make him hungry . Just don't smoke it, vaporizing it or using it in food (made into butter, melted and mixed in liquid nutrition).

Keep your chin up and good luck.

Eric

Also have someone determine if he is dehydrated or not as that also can lead to the Big C and nausea. He must get adequate water, some suggest a minimum of 48 ozs each and every day during this Tx. All of this needs immediate attention or like a snowball rolling down a hill it will only get bigger meaning worse.

If it is not the constipation, it could very well be that he isn't tolerating something in the food. We too had to try multiple liquid nutritionals before we found one that didn't cause the vomiting. I also have to agree with Eric S on the usefulness of the MJ, it is very easy to get a license and there are dispensaries on almost every corner here in Washington. The MJ was the only thing that helped my husband at the point you are. Gotta get those bowels moving though, lots of water and we used to push mylanta through his tube too.
My heartfelt support to you.
Jennie

Wow, thanks to everyone for their support! I feel like I am not the only one now. Will try the feeding ONE MORE TIME and if it does not take, off to the oncologist.
Wish us luck and I really appreciate all your comments.
Tina

There is a simple test to determine if he is dehydrated and that is to pinch the skin on the top of the hand between two fingers and pull it up slightly and if it stays up then it's one sign that his body needs more liquid. You can't mess around with dehydration. It can lead to kidney failure quickly.

Nestle makes a formula called Compleat. It is make with some "real" food and it sometimes works better for people who are having trouble tolerating other formulas.
# Developed for patients with intolerance to semi-synthetic formula
# Helps promote beneficial bacterial growth and normal bowel function
From the treatment you described it sounds like what my sister had. She is very small, 4'11 and went to under 90 lbs. We made her tube feeding from "real" food. I'm an RN and I stayed with her throughout her treatment so I was able to evaluate changes we needed to make. Making it is very time consuming but we feel it was worth it. I found out about Compleat when one of the surgeons told us we couldn't use our own food. That is another story for another time.
Good luck.

Having had the same experience myself, I want to re-empathasize what Brian stated: Constipation can cause ALL of those issues. For many of us here it was the WORST part of treatment - worse than mouth sores even. I spent many days, curled up in a fetal position, on the bathroom floor. Constipation causes stoppage of homeostatis so, yes, everything in the stomach will be evacuated orally. Narcotics can cause this VERY rapidly.

Get to the hospital nutritionist right away.

As David posted STAY HYDRATED, this will help with the constipation and the fluids must be replaced if he is vomiting.

All the posters here have offered good suggestions, feeding techniques, etc. So you will have to experiment with different methods to see what works. Be patient it's not easy (what an understatement).

No one mentioned antacids, but Cisplatin does a number on the GI tract so talk to the MO about that as well.

This situation could get out of control very quickly.

Kudos to you for being a great and loving caregiver - it is much harder than being a patient. I have done both so I speak from experience.