Thanks Cheryl and Charm for your great suggestions. Take care, Linda

There are so many reasons why post and late treatment causes nausea that a systematic approach to isolate the cause is necessary:
1. Stringy mucous in the main one. This should resolve itself on its own within 1-3 weeks post Tx. My strategy was to use pick magic first, then drink some lukewarm water. this would often break it up a little. Don't attempt feeding until he is awake for a bit,
2. Reaction to chemo is #2. Antiemetics may help
3. Gastrointestinal upset from Cisplatin (in particular) Pepcid AC or Famatodine
4. Constipation. Stoppage of homeostasis will definitely cause nausea. Stool softeners, fiber in diet - STAY HYDRATED
5. Reaction to other meds, especially narcotics.
6. Aspiration - this can happen if you swallow the "swish & spit" "Pink Magic".
7. Food cooking odors.
8, Psychosymatic anti-anxiety meds
9. Dehydration -STAY HYDRATED. (this should actually be between 3 and 4.
There are probably more.

Again, a late reply sorry.

Yes, yes, yes to the obstruction issue. Alex continues to struggle with this. Both the tumour,which was approx 4cm, and the radiation damaged his throat quite extensively. He complains of food getting stuck like it hits a ledge and then won't go further. Alex is still not eating properly. He came off his PEG in May, 12 months after it was inserted and continues to get the majority of his nutrition through liquid Ensure Plus (9 cartons per day).

Get your brother onto a speech pathologist when he is through his treatment and feeling well enough (but be prepared and allow him to take a breather from doctors as he may need a bit of space) and they may recommend a barium swallow. This marvellous technique allows them to video tape his swallowing mechanism and watch how food goes down including how and where it gets stuck. The speech therapist/pathologist will be able to give him exercises and tips to help him. There should be one allocated to his case as part of the multi-disciplinary team

Thanks Gary, for that wonderfully comprehensive reply. I've only just found it and am emailing your list to my brother immediately. Linda

Thanks Karen, that's very sound advice and I'll pass it on. Alex's diagnosis sounds not disimilar to Simon's. Where was he treated?

Hi Samkl

Royal North Shore.

Completely irrelevant to your question but something I noticed in your posts, I remember you said you were trying to get Simon on the forum but you also said he doesn't want the details. Very few "teams" have more than one person on the forum. It seems that the person who needs to know the ins and outs of everything before it happens is the person that ends up on the forum. The person who just wants to get through is less likely to hit the boards.

My Alex is/was like Simon and refused to get on the forum at first. He trusted me to "sanitise" the information and drip feed him with the necessary information as he needed it. His greatest fear was that he would be unable to deal with what he read on this forum. I have learned the "head in the sand" technique is a common one and is the only way some people can cope with this.

Over time, I learned which stories on the forum resonated with Alex either in terms of attitude or similarity in issues and shared the posters' pearls of wisdom when appropriate. There were nights in hospital where I would repeat what I could remember of a particular string and we would laugh till we cried over some of the comments and humourous side tracks from topic. Others have printed out material and left it around for reading. Alex is now registered to the forum and lurks regularly but never writes but this is an unusual thing to have both survivor and carer on the forum.

From this forum I learned that I should back off sometimes, and that too much advice is overwhelming and annoying. I often thought Alex was making life more difficult for himself but had to accept that at the end of the day it IS his life and I have a duty to do what he wants, not what I think is best. I failed miserably trying to adhere to this, but it is always on my mind usually 2 seconds AFTER I open my mouth and stick my foot in it.

You are clearly a caring, hands on sister, who is desperate to help Simon with everything in you even though you are 2000 miles away. He knows this, but when he is in pain, or frightened, or distraught, he may forget momentarily and be a little insensitive to your efforts. If this happens, remember it is not your brother but the pain or the cancer or the fear driving it.

I might add that I threw up so much from the Cisplatin that the stomach acid polished my teeth. Unfortunately, I was in the 40% that the anti-emetics don't work on. All of that lost nutrition and fluids had to be replaced but I still ended up in the ER several times for IV rehydration.

Finally I got smart and booked the rehydration in the infusion unit instead - I was in and out in an hour vs. 4 hrs in the ER. Evidently in the ER they have to drip it in slowly because you must be constantly monitored. Then there's the cue time just getting into the ER.

And for you ladies, men often express fear or depression with anger.

Something to thin out the mucous so you can clear it more easily like plain robitussin or regular mucinex (same active ingredient) and then someting to dry it up to stop the dripping into the stomach, which causes nausea. A portable home suction unit was helpful for me b/c I had a hard time clearing my secretions by spitting after my partial glossectomy.