| Joined: Oct 2013 Posts: 24 Member | OP Member Joined: Oct 2013 Posts: 24 | My sister is having an incredibly difficult time swallowing due to the pain its causes...so much so that she isn't getting the nutrients she needs. The cancer is on her tongue, but her main source of pain is her throat. We saw the doctor Monday and he put her on liquid morphine to get her through until her surgery this coming Monday. That has proven to offer little relief. She had been doing pretty good drinking Ensure when she wasn't hungry and eating soft foods when she did have an appetite, but now we are having a hard time getting her to even drink enough water.
Last edited by RebeccaH.; 11-13-2013 01:44 PM.
Sister, 18yr old, diagnosed with oral tongue cancer 10/08/13 Total Glossectomy and neck dissection 11/18/13 (saved the back left portion of her tongue base only) Forearm flap reconstruction Trache and NG feeding tube after surgery (both removed now) Tumor 6.7 cm All lymph nodes tested came back negative for cancer Radiation- 30 treatments (ending 2/18/14) 3/20/14 Recurrence- tumors in both lungs; likely metastasis
| | | | 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 | If she isnt able to eat or drink enough to sustain herself, she will need a feeding tube. This is something most patient detest! But its not a choice for some, like your sister. She MUST take in enough or she will feel horrible. When going thru radiation she would need a minimum of 2500 calories and 48 oz of water every single day. Her body is burning up calories like crazy and she will very soon become dehydrated and malnourished. This can cause hospitalization and possibly a delay in her surgery.
A nasal feeding tube can be inserted right there in the office and is a great temporary fix. For a longer term use, she would need whats called a PEG tube. This goes directly into her stomach.
Call the doc and let them know how badly she is doing with her intake. Something must be done right now! Do not take NO for an answer, insist on the doctor helping her immediately. You have to stand up and be her voice, speak up for her and get her the help she needs.
PS... Ask for pain meds too. Nobody should have to suffer on pain like what you described. 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: Oct 2013 Posts: 24 Member | OP Member Joined: Oct 2013 Posts: 24 | We have called 3 times trying to talk to a nurse at her doctor's office today and are still waiting for a call back. Is it reasonable to take her to a local ER for IV fluids or am I over-reacting?
Sister, 18yr old, diagnosed with oral tongue cancer 10/08/13 Total Glossectomy and neck dissection 11/18/13 (saved the back left portion of her tongue base only) Forearm flap reconstruction Trache and NG feeding tube after surgery (both removed now) Tumor 6.7 cm All lymph nodes tested came back negative for cancer Radiation- 30 treatments (ending 2/18/14) 3/20/14 Recurrence- tumors in both lungs; likely metastasis
| | | | Joined: Oct 2013 Posts: 24 Member | OP Member Joined: Oct 2013 Posts: 24 | I don't know what else to ask for. She's been on Loratab, then Percocet, and now this liquid Morphine. She was doing a lot better while she able to take pain medicine along with Ibuprofen, but now that surgery is so close they told her to stop taking it. Is a steroid beneficial in reducing this kind of swelling?
Sister, 18yr old, diagnosed with oral tongue cancer 10/08/13 Total Glossectomy and neck dissection 11/18/13 (saved the back left portion of her tongue base only) Forearm flap reconstruction Trache and NG feeding tube after surgery (both removed now) Tumor 6.7 cm All lymph nodes tested came back negative for cancer Radiation- 30 treatments (ending 2/18/14) 3/20/14 Recurrence- tumors in both lungs; likely metastasis
| | | | 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 | If you think your sister is dehydrated and needs the IV fluids now, then yes take her to the ER. I would call first thing in the morning and then again at noon. Tell the receptionist that it is an emergency and you need to speak with the nurse ASAP. They can actually page the nurse and get her on the phone if they really want to. Dont ever forget all these people work for YOU (well, really your sister but you are her advocate so you call the shots). Speak up and get them to do something right away. Your sister cant go all weekend without taking in enough fluids or calories. No wonder the poor girl feels horrible.
Good luck! 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: Oct 2011 Posts: 225 "OCF Down Under" Gold Member (200+ posts) | "OCF Down Under" Gold Member (200+ posts) Joined: Oct 2011 Posts: 225 | Rebecca, many people here have been hospitalised because they were dehydrated. Don't take no for an answer. I couldn't agree with ChristineB more. Patients really need an advocate when they enter a health system, in any country.
It occurred to me that with an 18 year old sister you must be quite young yourself. I'm sorry you're both going through this, and I hope there are others around you, supporting you.
Brother 49yo DX 22/6/11 Tonsil SCC HPV+ Stage IV T4N1(?)M0. Carbo/docetaxel (Taxotere)19/7, 11/8 (with E-tux), 1/9; E-tux 11/8, 25/8, 15/9, 30/9, 14/10, 28/10; IMRT X 35 (70gy tumour;63gy nodes;56gy gen area) 19/9-4/11/11. Clear PET scan 1/2/12. 1 and 2 year post treatment checks good. | | | | 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 | Even during Tx and under the care of Moffitt, a top rated CCC, I ended up in the ER 3 times to get much needed fluids so DO take her immediately. I doubt anyone will bother with a feeding tube a few days before surgery but they may post surgery depending upon what happens then.
What have they said they will do in surgery?
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: Dec 2010 Posts: 5,264 Likes: 5 "OCF Canuck" Patient Advocate (old timer, 2000 posts) | "OCF Canuck" Patient Advocate (old timer, 2000 posts) Joined: Dec 2010 Posts: 5,264 Likes: 5 | She absolutely should go to the re. They may opt to keep her in until. Monday - poor thing tongue pain is brutal, best of luck Monday, if she is at home try milky liquids they coat and sooth, hugs
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
| | | | Joined: Oct 2013 Posts: 24 Member | OP Member Joined: Oct 2013 Posts: 24 | We took her to the ER and she was given IV fluids and Ativan. One of the surgeon's in her group came down and talked to us. She said come hell or high water, they are doing the surgery Monday. Our goal is to get at least 3 Ensure shakes and as much water as possible down her until then. They weren't overly concerned about dehydration at this point, saying they can provide her needed fluid via IV at the time of surgery. So, now we wait.
Sister, 18yr old, diagnosed with oral tongue cancer 10/08/13 Total Glossectomy and neck dissection 11/18/13 (saved the back left portion of her tongue base only) Forearm flap reconstruction Trache and NG feeding tube after surgery (both removed now) Tumor 6.7 cm All lymph nodes tested came back negative for cancer Radiation- 30 treatments (ending 2/18/14) 3/20/14 Recurrence- tumors in both lungs; likely metastasis
| | | | Joined: Oct 2013 Posts: 24 Member | OP Member Joined: Oct 2013 Posts: 24 | Likely a jaw split (we're really hoping not), partial glossectomy with reconstruction from forearm, neck dissection, trache, feeding tube and skin graft from her thigh to her forearm.
Sister, 18yr old, diagnosed with oral tongue cancer 10/08/13 Total Glossectomy and neck dissection 11/18/13 (saved the back left portion of her tongue base only) Forearm flap reconstruction Trache and NG feeding tube after surgery (both removed now) Tumor 6.7 cm All lymph nodes tested came back negative for cancer Radiation- 30 treatments (ending 2/18/14) 3/20/14 Recurrence- tumors in both lungs; likely metastasis
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