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#153268 08-15-2012 05:49 AM
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Lea Offline OP
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It's been just over a month since my dad's surgery and I can say that with each day he's getting stronger and better. We meet the radiologist this week to discuss treatment options. I assume he will be starting radiation in the near future. The Path results came back - out of the 77 lymph nodes removed 3 were affected on the left side. Over 70% of his tongue was removed.
My dad's main source of nutrition comes from his feeding tube (g-tube). However, the past couple of days, he's been having cravings for soup. Initially we didn't think much of it. He's been practicing his swallowing with a teaspoon and water. Some days seem easier than others. But, what surprised us all was that he managed to swallow the soup and finished a bowl of it. The constancy was thin (slightly thicker than broth). I am concerned that there is a possibility there's fluid that leaks into the wind pipe and he�s not feeling it. He didn�t have the need to cough afterwards. I am cautiously happy about this. I was curious if others have had similar experiences - after having a total glosectomy we didn't think he'd be swallowing so soon.


CG - Father, Age 63, Non-Smoker
May 2012 - Diagnosed Stage IV Tongue Cancer (Left Side)
July 2012 - Surgery (Removed: 70% of Tongue & 77 Lymph Nodes - 3 Affected; Flap Reconstructed; G-Tube)
August 2012 - Teeth Removed; MRI Scan: 1 New Affected Lymph Node
Sep-Nov 2012 - 35 x Rad & 2 x Cisplatin Chemo

Lea #153271 08-15-2012 06:08 AM
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Your father should get a swallowing test done. I believe the correct term is a barium swallow test. I know Charm has done several of these so he can give you all the details. You need to be certain your father is not aspirating when he tries to eat.


Christine
SCC 6/15/07 L chk & by L molar both Stag I, age44
2x cispltn-35 IMRT end 9/27/07
-65 lbs in 2 mo, no caregvr
Clear PET 1/08
4/4/08 recur L chk Stag I
surg 4/16/08 clr marg
215 HBO dives
3/09 teeth out, trismus
7/2/09 recur, Stg IV
8/24/09 trach, ND, mandiblctmy
3wks medicly inducd coma
2 mo xtended hospital stay, ICU & burn unit
PICC line IV antibx 8 mo
10/4/10, 2/14/11 reconst surg
OC 3x in 3 years
very happy to be alive smile
Lea #153273 08-15-2012 06:25 AM
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Lea

It's wonderful that your Dad can swallow so soon after his surgery. When I was still recovering from surgery, I was assigned a Speech Language Pathologist (SLP) who showed me the teaspoon of water exercise but I was aspirating so we stopped.

My advice would be to ask the doctor for prescription for a modified barium swallow test (MBS). It's jointly administered by a SLP and radiologist. It also has different names: videofluoroscopic swallowing study, or videofluoroscopy; esophagram; or cookie swallow (although it's usually crackers)

Basically he will sit or stand next to an x-ray machine. The SLP will give him different foods and drinks mixed with barium . The barium makes the food and liquid show up on the x-ray. The SLP will ask him to do different things during the test. He may try soft foods and hard foods, and thin liquids and thick liquids. He may take small amounts and large amounts. He may be asked to move his head in different positions. He may also try things like swallowing hard. Ask that the test be recorded so it can be watched again later.

The MBS not only tells you whether there is aspiration but also lets the SLP see what muscles are not working or where the exercises can help most.


65 yr Old Frack
Stage IV BOT T3N2M0 HPV 16+
2007:72GY IMRT(40) 8 ERBITUX No PEG
2008:CANCER BACK Salvage Surgery
25GY-CyberKnife(5) 3 Carboplatin
Apaghia /G button
2012: CANCER BACK -left tonsilar fossa
40GY-CyberKnife(5) 3 Carboplatin

Passed away 4-29-13
Lea #153275 08-15-2012 07:19 AM
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Lea Offline OP
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Thank you for the advice. He has done one swallow study but it was done 2 wks after surgery. I have called the speech therapist and asked if we can book a follow up study. His swelling is down and he's much more alert now. We found that wk 3 he was still very tired and would fall asleep in mid conversation. By wk 4 he was up and present. That�s when he began practicing with water and a tsp. Hopefully we can get a second study scheduled soon.


CG - Father, Age 63, Non-Smoker
May 2012 - Diagnosed Stage IV Tongue Cancer (Left Side)
July 2012 - Surgery (Removed: 70% of Tongue & 77 Lymph Nodes - 3 Affected; Flap Reconstructed; G-Tube)
August 2012 - Teeth Removed; MRI Scan: 1 New Affected Lymph Node
Sep-Nov 2012 - 35 x Rad & 2 x Cisplatin Chemo

Lea #153326 08-16-2012 08:31 AM
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What was the result of the first study he had done? The biggest issue after I lost half my tongue was moving food to the back of my mouth so that I could swallow, but once I got it there I was okay. Since he hasn't had radiation yet he should still have a good coughing reflex if he is aspirating, so the fact that he's not coughing is a great sign. If he did aspirate he'd also risk pneumonia and the fact that he hasn't is another great sign. Get another study done and if he passes that feed him and fatten him up before he starts treatment. The treatment is tough at any age but especially tough on the elderly. Good luck to you and your Dad!!


55 y/o
SCC LL Tongue 3/27/07
Part. mandibulectomy 9/2/07
Left ND 5/12/08
RT/Chemo
Rec LL Tongue 07/09
Part gloss 8/5 & 8/25
Surg 10/28/09 re mets to R neck & L jaw
RT & Chemo finished 12/22/09
PEG fitted 05/06/10
L buccal SCC 10/10
freeflap (forearm)surgery 2/28/11 L buccal and gingiva
Lea #153327 08-16-2012 08:37 AM
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What was the result of the first study he had done? The biggest issue after I lost half my tongue was moving food to the back of my mouth so that I could swallow, but once I got it there I was okay. Since he hasn't had radiation yet he should still have a good coughing reflex if he is aspirating, so the fact that he's not coughing is a great sign. If he did aspirate he'd also risk pneumonia and the fact that he hasn't is another great sign. Get another study done and if he passes that feed him and fatten him up before he starts treatment. The treatment is tough at any age but especially tough on the elderly. Good luck to you and your Dad!!


55 y/o
SCC LL Tongue 3/27/07
Part. mandibulectomy 9/2/07
Left ND 5/12/08
RT/Chemo
Rec LL Tongue 07/09
Part gloss 8/5 & 8/25
Surg 10/28/09 re mets to R neck & L jaw
RT & Chemo finished 12/22/09
PEG fitted 05/06/10
L buccal SCC 10/10
freeflap (forearm)surgery 2/28/11 L buccal and gingiva
Lea #153380 08-17-2012 11:53 PM
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I have found that the best way to get food to the back of the mouth is by taking a drink of water. - BUT - this is important. _ the drink needs to come from a water bottle which shoots the water to the back of your throat. A glass of water does not work - the water needs to come from a bottle. Good luck.

Donna


Donna,69, SCC L Tongue T2N1MO Stg IV 4/04 w/partial gloss;32 radtx; T2N2M0 Stg IV; R tongue-2nd partial gloss w/graft 10/07; 30 radtx/2 cispl 2/08. 3rd Oral Cancer surgery 1/22 - Stage 1. 2022 surgery eliminated swallowing and bottom left jaw. Now a “Tubie for Life”.no food envy - Thank God! Surviving isn't easy!!!! .Proudly Canadian - YES, UNIVERSAL HEALTH CARE IS WONDERFUL! (Not perfect but definitely WONDERFUL)
Lea #153414 08-19-2012 08:09 AM
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Thicker drinks like almond milk help too. wink


Cheryl : Irritation - 2004 BX: 6/2008 : Inflam. BX: 12/10, DX: 12/10 : SCC - LS tongue well dif. T2N1M0. 2/11 hemigloss + recon. : PND - 40 nodes - 39 clear. 3/11 - 5/11 IMRT 33 + cis x2, PEG 3/28/11 - 5/19/11 3 head, 2 chest scans - clear(fingers crossed) HPV-, No smoke, drink, or drugs, Vegan
Lea #153451 08-20-2012 07:32 PM
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It is very important that you get the barium swallow tests. I have had many and trying on my own has landed me in the hospital 2 times for asperating turning into pneumonia. I am still working with my speech pathologist. I wish they would let me eat something a little thicker but after this last bout with pneumonia I can not even drink water. They say my muscles are working so I look at it as if water is too thin let me try real food. I have an appointment soon and hopefully they will agree with me. Good luck and stay safe with liquids.


10/10 IV OSCC metastatic to lymph nodes. 10/10 Peg,Port,Trech. due to rad scarring cannot swallow. 9/12 Pet clean. SCC back again 11/12. Tumor attached to jugular, Rad DX left side of neck 11/19/12. No Chemo or Rads. MRI on 1/11/13 for chronic pain w/pet scan 2/15/13.
Lea #154995 09-24-2012 11:16 AM
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This is my first time to actually respond. I've been reading all the comments for several mos however. My sister in law is a dental hygenist and she told me about the website. My cancer was 16 yrs ago. I had surgery the first time and a year later it reoccured so I had 8 weeks of radiation. My cancer was on the posterior pharngeal wall. It was scc and was poorly differentiated so was aggressive type. They really gave me a big dose of radiation and my mouth was very sore for over a year and still after 15 years I am having swallowing issues and problems with sore mouth and very freq dental issues. I also have contacted atypical mycobacteria in my lungs. I have been on many antibiotics over the years and still have a constant chronic cough and pneumonia and bronchitis and have positive sputum cultures for the atypical mycobacteria. Recently I've had swallowing problems because my saliva has never gotten much better or my taste has not returned much either. I go for more texture than taste. I lived on oatmeal and poached eggs for a year. That miracle mouthwash isn't really a miracle when it comes to swallowing!! I never had a feeding tube because my dr believed my best chance was if I was on the edge between living and dying. So I got the nutrition I needed from what I could swallow only which wasn't a lot. It seems from most of the things i"ve read that the radiation has improved a lot since I had treatment and that a lot of folks have tongue rather than throat cancer. My voice is still pretty much the same for that I"m lucky. I do have issues with swallowing and did have a recent barium swallow test and most anything just hangs up in my throat. I've had to have the heimlich done and that was very scary. I'm seeing a SLP now for some exercises and I have in the past as well. Does anyone have any good suggestions. I know that I"m lucky that I have my tongue and jawbone and some taste. I do like chooolate milkshakes and mac n cheese and spaghetti and mashed potatoes though the potatoes are not really that tasty just easy. I attempt meat and really everything but can't say I enjoy it. For one thing my mouth is very sensitive to even ketchup and things that most would say is not spicy at all ia extemely spicy to me. My husband tests a lot of things for me first to make sure I can eat it. Though even he sometimes thinks it is fine and it makes my eyes water. Even the barium stuff that they gave me with the swallow test burned my mouth. It is my tongue and soft palate and throat all the way down. Everyone pretty much looks in and says it looks good no tumors or anything like that which is good and I'm thankful but it still hurts and isn't much fun to eat. I have a hard time maintaining my weight as well.
Well good luck to all of you. YOu all make me feel lucky because you are hanging in there and doing well. I really appreciate all you telling your stories and sharing information.


65f dx 7/95 scc poorly differentiated r post pharngeal Laser surg
7/96 reocur l post wall 8wks IMRT 5d/wk
freq check all clear ca
97 approx dx atypical mycobacteria lungs picc line many antibiotics still pos cultures
cough
dysphagia
dry mouth
many dental issues
osteoporosis many fxs
Poor appetite

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