| Joined: Aug 2011 Posts: 596 "Above & Beyond" Member (500+ posts) | OP "Above & Beyond" Member (500+ posts) Joined: Aug 2011 Posts: 596 | Hi, Everyone.
I was told last Monday that I will be getting a PEG place "in a couple of weeks", meaning that the RN has to book the procedure and go through all of the insurance hoops to do so.
Now, almost a week later, I am having quite a difficult time swallowing and have a good deal of mucuositis. I can barely get down 2 Boosts today and a 20 bottle of water. I KNOW this isn't good, I just don't know what to do. I'm seeing my RO tomorrow for my regular check ups. I'm swishing, rinsing, spitting, magic-mouth-washing, and the whole bit. I have been keeping up with my pain meds.
I just don't know how long I can go on like this.
Kerri
37 y/o fem at Dx (23 wks preg @ dx on 3/16/11) SCC L oral tongue (no risk factors) L partial gloss/MND 3/28/11 @ 25 wks preg T1-2N0M0; no rads/chemo Tonsillectomy on 8/6/12 +SCC L tonsil T2-3N1M0 (HPV-) Treated with 35 rads/7 carbo & taxol (Rx ended 10/31/12), but many hospitalizations d/t complications from rx. Various scans since rx ended are NED! Part of genetic study for rare cancers @ MGH. 44 years old now...I wasn't sure I would make it! Hoping for 40 more!
| | | | Joined: Sep 2009 Posts: 618 "Above & Beyond" Member (500+ posts) | "Above & Beyond" Member (500+ posts) Joined: Sep 2009 Posts: 618 | Kerri,
I'm pretty sure that if you tell your RO what you just told us, he will make sure that PEG is in ASAP. He may also get you a tube that goes down your nose in the interim. I forget the name but a few here have had that. It will hold you over until the PEG is ready. From what I hear its a bit uncomfortable but no big deal.
Kelly Male 48, SCC (Soft Palet) Rt., Stage 1, T3n0m0, Dx, 8-09, Start IMRT 35 9-2-09 end 10-21-09 04-20-10 NED 8-11 recurrence, node rt. neck N2b 10-11 33 IMRT w/chemo wkly 3-12-12 PET - residual cancer 4-12 5 treatments with Cyberknife & Erbitux 6-19-12 Pet scan CLEAR 12-3-12 PET - CLEAR
| | | | Joined: Jul 2012 Posts: 3,267 Likes: 4 Patient Advocate (old timer, 2000 posts) | Patient Advocate (old timer, 2000 posts) Joined: Jul 2012 Posts: 3,267 Likes: 4 | Yes, the peg or nasal tube will help. They may give liquid pain meds, being they they are more direct, and absorbed quicker, and an anti inflammatory to reduce the inflation. Usually they should be able to tell if it is recurrent from the primary, metatastic, or a new cancer from examination of the biopsy sample dine by the pathologist. best of luck.
10/09 T1N2bM0 Tonsil 11/09 Taxo Cisp 5-FU, 6 Months Hosp 01/11 35 IMRT 70Gy 7 Wks 06/11 30 HBO 08/11 RND PNI 06/12 SND PNI LVI 08/12 RND Pec Flap IORT 12 Gy 10/12 25 IMRT 50Gy 6 Wks Taxo Erbitux 10/13 SND 10/13 TBO/Angiograph 10/13 RND Carotid Remove IORT 10Gy PNI 12/13 25 Protons 50Gy 6 Wks Carbo 11/14 All Teeth Extract 30 HBO 03/15 Sequestromy Buccal Flap ORN 09/16 Mandibulectomy Fib Flap Sternotomy 04/17 Regraft hypergranulation Donor Site 06/17 Heart Attack Stent 02/19 Finally Cancer Free Took 10 yrs
| | | | Joined: Jun 2007 Posts: 10,507 Likes: 7 Administrator, Director of Patient Support Services Patient Advocate (old timer, 2000 posts) | Administrator, Director of Patient Support Services Patient Advocate (old timer, 2000 posts) Joined: Jun 2007 Posts: 10,507 Likes: 7 | Kerri, so sorry you are beginning to struggle! I agree, a nasal tube is great for the short term use. This is in case you arent able to get the peg tube quickly.
Just remember even if it hurt, you must continue to swallow every single day. This is to keep those muscles active. Its necessary even sipping water several times a day will be enough. But.... you MUST continue to get 48 oz of water and 2500 calories every single day. If not you face a good possibility of dehydration and malnutrition creeping up on you. Push yourself to drink more. I would really hate seeing you wind up in the hospital from not being able to take in enough. Please be careful and take care of yourself. ChristineSCC 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 | | | | Joined: Sep 2006 Posts: 8,311 Senior Patient Advocate Patient Advocate (old timer, 2000 posts) | Senior Patient Advocate Patient Advocate (old timer, 2000 posts) Joined: Sep 2006 Posts: 8,311 | I had a nasal tube for only 2 weeks and it really helped me. They can put it in while you sit in a chair. No pain, 2 mins, that's it. You do have to get an x ray to make sure the tube is properly placed in the stomach and then they pull the thin metal strip from the tube and you're go to go. I even was allowed to pull it out at home when I didn't need it anymore.
David
Age 58 at Dx, HPV16+ SCC, Stage IV BOT+2 nodes, non smoker, casual drinker, exercise nut, Cisplatin x 3 & concurrent IMRT x 35,(70 Gy), no surgery, no Peg, Tx at Moffitt over Aug 06. Jun 07, back to riding my bike 100 miles a wk. Now doing 12 Spin classes and 60 outdoor miles per wk. Nov 13 completed Hilly Century ride for Cancer, 104 miles, 1st Place in my age group. Apr 2014 & 15, Spun for 9 straight hrs to raise $$ for YMCA's Livestrong Program. Certified Spin Instructor Jun 2014.
| | | | Joined: Nov 2010 Posts: 167 Senior Member (100+ posts) | Senior Member (100+ posts) Joined: Nov 2010 Posts: 167 | Hey Kerri -same thing happened to me around week 3 - my swallow just wasn't going to do what I know it needed to do. It took a couple days to get my PEG in so I went for daily hydration sessions which helped a lot. It was a low point for me though- I felt like my body was betraying me! I hope you're able to get alternate nutrition ASAP - I know you know how important adequate nutrition/hydration is.
Hang in there Kerri - you WILL get through this! Jen
Jennifer (39) 02/10 SCCa Tongue & Base, HPV- 03/10 Partial Glossectomy & ND 11/10 Revision due to additional nodes 12/20-2/2/11 IMRT & concommitant chemo 2/11 PEG in 3/11 PEG out Back at work and feeling good 03/24/11! 12/20/11 - 9 month f/u PET/CT - all clear!
| | | | Joined: Aug 2012 Posts: 56 Supporting Member (50+ posts) | Supporting Member (50+ posts) Joined: Aug 2012 Posts: 56 | Kerri--two things. First, the above postings might make nasogastric (NG) tubes and percutaneous endoscopic gastrostomy (PEG) tube. NH tubes are inserted through the nose and into the stomach via the throat; it is not unlike the way many of us have had our throats or tongue examined by a small lighted camera inserted similarly. A local anesthetic spray makes it easier, and an Xray confirms it is properly in the stomach. It is temporary, usually used when it will only be needed for days or weeks. It extends out of your nose, which can be irritating. It is not as unsightly as it sounds, however, because it is very small in diameter. They have the advantage of stimulating swallowing so that reflex is maintained.
The PEG tube you are being scheduled for is a minor surgery wherein a hole is made though the wall of your abdomen so a somewhat larger tube can be passed directly into your stomach through a port made into the wall of the stomach itself. It is done under light sedation and local anesthetics. The tube extends onto your abdomen and is hidden under clothes. It can be left in place longer. There are some potential complications, such as leaking or infection (not common usually). One concern is that pts may fail to swallow once the tube is placed, as they no longer need to and the tube does not stimulate swallowing. It is removed in a doctor's office.
The NG tube could be used temporarily, or depending on how long-term and intense your needs are, could be all that is needed. My treatment center prefers to avoid them in favor of the NG tube unless there is no other choice; opinions vary about this, and if one is likely to need a PEG tube eventually most will just go with that from the onset.
Meds and foods can be given through both types, though NG tubes, being smaller in diameter, may allow for a smaller range of nutrient types to be used.
Second, you are not alone in having trouble getting enough calories and being discouraged. I am going through that myself and have posted a separate entry in this forum seeking ideas to help me boost my intake so I can hopefully avoid a tube. Our trials are in most cases temporary and many before us here have gotten through similarly hard times and hopefully are offering encouragement to you. We will get through this, whether we end up with a temporary tube or not!
Ed H, NE Ohio SCC BOT with lymph node involvement, HPV+, diagnosed 7/12 Radiation and Cisplatin
| | | | Joined: Aug 2011 Posts: 596 "Above & Beyond" Member (500+ posts) | OP "Above & Beyond" Member (500+ posts) Joined: Aug 2011 Posts: 596 | Thank you, Ed. I will be going with the PEG since they anticipate that it will be there for awhile and the have a swallowing specialists that will be working with me the entire time and during the rehab process. I feel that I am in in good hands.
Thank you for sharing you experience. It's good to know how others have fared with different treatment options. I hope you are doing well and continue to do so. I have not been as active on these forums over the last couple of months with my new diagnosis and treatment plan, you'll see me back her more frequently as I start to feel better!
Good night! I've a got an early morning ahead of me! Take care, Kerri
37 y/o fem at Dx (23 wks preg @ dx on 3/16/11) SCC L oral tongue (no risk factors) L partial gloss/MND 3/28/11 @ 25 wks preg T1-2N0M0; no rads/chemo Tonsillectomy on 8/6/12 +SCC L tonsil T2-3N1M0 (HPV-) Treated with 35 rads/7 carbo & taxol (Rx ended 10/31/12), but many hospitalizations d/t complications from rx. Various scans since rx ended are NED! Part of genetic study for rare cancers @ MGH. 44 years old now...I wasn't sure I would make it! Hoping for 40 more!
| | | | Joined: Apr 2012 Posts: 111 "OCF across the pond" Senior Member (100+ posts) | "OCF across the pond" Senior Member (100+ posts) Joined: Apr 2012 Posts: 111 | Hi Kerri, good luck with the PEG. I had mine in for 5 mths and although very irritating at times, it really relieved the worry of not being able to eat and meant that my weight loss was not too great. I was quite sore for a few days afterwards, hope you are not too bad. Sally
Dx 10/11 51yrs LBOT Stage 4 2nodes HPV16+. Non-smoker mod alcohol. 10/11 Induction chemox2 (Docetaxel, 5-Flu, Cisplatin) then Cisplatinx2 IMRTx30. Ended 01/13/12. 12/07/11 RIG. RIG removed 05/05/12. 4/12 CT scan clear. Visual scope checks clear as of 10/13. Learning to live with eating challenges.
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