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#41058 04-28-2007 01:57 PM
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Hi..My husband will be starting his 3rd week of radiation. Today when visiting him I was told he had a high temperature 38.4 and it was fluctuating up and down at times. His BP dropped slightly, he has diarrhea and he is drinking water but only taking very small amount of drinks. He is taking 2 can of Nutren for the day through his feed tube. The nurses are thinking he may have an infection??? He is complaining of being weak and he wants to sleep all the times. He takes a sleeping pill at night. Any suggestions. I have asked the nurses to look into his feed. He appears not as confident as he was a few days ago.


Carol CG to Husband age 60 Stage IV SCC right tonsil T4AN2B tx rad x 35 chemo x 2 Currently after treatment no sign of cancer in throat. (all clear to date)
#41059 04-28-2007 06:41 PM
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Hi Mom,

If he's got a fever, he's likely got an infection of some sort. Radiation won't cause him to have a temperature.

He's also almost certainly starting to feel the effects of radiation. I hate to say so, but he's likely going to get a lot worse before it gets better.

Fatigue and weakness are certainly symptoms of radiation, and since the therapy is cumulative, it will likely be followed by the mouth sores, mucocitis, etc.

It is CRITICAL that he gets enough nutrition and water daily. Since he has a PEG, and is already in the hospital, the medical staff should have a good handle on that, but if he's only being given 2 cans of Nutren a day, sounds like you may need to be making some noise. That's inadequate calorie wise, and he also needs a couple of liters of water a day at an absolute minimum. Without it, he will be really sick, really quickly.

HIs confidence is probably slipping because he's a sick guy, and getting sicker because of the treatments he's receiving. You have to keep him upbeat as much as you can. It's a tough thing, for both him and you, but it is important.

Wayne


SCC left mandible TIVN0M0 40% of jaw removed, rebuilt using fibula, titanium and tissue from forearm.June 06. 30 IMRT Aug.-Oct. 06
#41060 04-29-2007 01:03 AM
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Thank you for you reply. I told the nurse a few days ago about my concern pertaining to his nutrition and the diarhhea. They felt 2 can 375 x 2 was enough with the rest of the resource plus, but he is now refusing to drink the resource plus saying he feels nausated. The doctor has ordered blood work and they are thinking now his electrolytes are out of wack. He is drinking water. I phoned earlier to day to see what could be done. Any suggestions appreciated. The fact that my husband will not allow any family members to see him...really hurts here...


Carol CG to Husband age 60 Stage IV SCC right tonsil T4AN2B tx rad x 35 chemo x 2 Currently after treatment no sign of cancer in throat. (all clear to date)
#41061 04-29-2007 03:27 AM
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I hear a lot of people use carnation instant breakfast. One type has 560 calories per 8 oz. serving.


DX 3-21-07 L tongue,SCC Stage IV (T3N2MO) TX Slash/Burn/Poison Method.
***Rapid Aggressive Recurrence 8-4-07 with same DX/TX. Life does not cease to be funny when people die any more than it ceases to be serious when people laugh. Never Give Up! ****UPDATE**** Our dear friend Petey passed away, RIP 9-2-07
#41062 04-29-2007 04:04 AM
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Mom,

I can't believe anyone thinks 750 cals per day is enough. I was told MINIMUM 48 oz water and 2000 cals each and every day.

Here's the info on Carnation VHC. may be a little different for Canada?

Try Carnation Instant Breakfast VHC. It has 560 nutritional balanced calories in a 8 oz can and will cut the misery and the time in feedings. You order it thru your pharmacy dept and some have suggested that if you get a prescription for it, your insurance company will pick up the tab. I only pay about $32.00 per 24 can case at Walgreens. That's only $5.00 a day for 2000 calories. Click on this link:

http://www.nestle-nutrition.com/family.aspx?objectID=86E49EB3-BE25-4B16-81D7-235E6F6E5183

Under the PURCHASE PRODUCTS tab, select FIND A PHARMACY NEAR YOU.

Under the PRODUCT NAME pull down, select Carnation Instant Breakfast Lactose Free VHC and fill in your zip code and they will give you a list of pharmacies that carries it.

At the top of that list note the Product Code and NDC Number in case that helps you when you call the store. When I call Walgreens it only takes a day or 2 at the most to get it delivered to the store and they call me when it's in.

You can also order it online but it usually costs more and takes much longer to get.

No, I do not work for the company nor do I get a commission (I wish) but this product made my feeding life during and post treatment much much easier and I am sure it will do the same for you


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.
#41063 04-29-2007 04:43 AM
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Thank you for your replies. I have tried to get the nurses in the hospital to understand that my husband needs 2300 calories a day. Yesterday he was given 2 can 375 x 2 for the entire day. When I questioned this I was told the dietitian would have to order more. His electrolytes are out of wack...he has diarhhea..and thinks the resource plus is coating his tongue and it is making his nausated. All in all I want to talk to the doctor on call today. Thank you. ps the Resource plus and Nutren is given freely but at the recommendation of the doctor.


Carol CG to Husband age 60 Stage IV SCC right tonsil T4AN2B tx rad x 35 chemo x 2 Currently after treatment no sign of cancer in throat. (all clear to date)
#41064 04-29-2007 05:57 AM
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David, everyone, Carnation VHC is not available in Canada, I checked.

Mom, Bene makes another product, Resource 2.0 (not plus) in vanilla and orange flavor that is very high calorie (much higher than the plus version). SInce he already has a PEG, it's probably easier to just feed through that.

Try and have him maintain his swallowing with water intake, and he needs to drink, a lot.

Also, there are councillors available and he needs to be in touch with them; he needs to have his family around him, and they need to be around him just as much.

I understand the not wanting anyone to see you this way, but speaking from personal experience, denying any family member access causes major problems that last long after the cancer battle has ended. They NEED to be with him, and allowing the that access isn't a sign of being weak.

Stay in touch
Wayne


SCC left mandible TIVN0M0 40% of jaw removed, rebuilt using fibula, titanium and tissue from forearm.June 06. 30 IMRT Aug.-Oct. 06
#41065 04-29-2007 06:18 AM
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In my experience if there's a temperature there's an infection. Radiation itself will not cause that but the tissue damage creates an environment that is more suseptible to picking up an infection. Are they talking about antibiotics?

I can't imagine why they're not all over the nutrition and hydration. We were told to get at least 2200 calories plus an additional 2 quarts of water. Have they misunderstood and think he is taking that by mouth?

Not being with family at a time like this is not helpful and I would be concerned that your husband is experiencing depression, a very common issue with this cancer. If he is withdrawing from his - and your - support network, that could be a symptom to discuss with the doctors. Fatigue is usually the radiation but it could also be depression.

You are right to express your concerns about all of this. I would want some answers from the medical team on what is going on here.

Regards JoAnne


JoAnne - Caregiver to husband, cancer rt. tonsil, mets to soft palate, BOT, 7 lymph nodes - T3N2BM0, stage 4. Robotic assisted surgery, radical neck dissection 2/06; 30 IMTX treatments and 4 cycles of cisplatin completed June 06.
#41066 04-29-2007 10:51 AM
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Hi, MP, do they gravity feed into his peg tube? And what kind of pain medication is he on? Amy in the Ozarks


CGtoJohn:SCC Flr of Mouth.Dx 3\05. Surg.4\05.T3NOMO.IMRTx30. Recur Dx 1\06.Surg 2\06. Chemo: 4 Cycles of Carbo\Taxol:on Erbitux for 7 mo. Lost our battle 2-23-07- But not the will to fight this disease

:
#41067 04-29-2007 01:20 PM
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He has a gravity feed tube. I wanted to put more feed into his tube (Resource Plus) but he refused to have it. Also he is refusing to drink the Resource Plus by mouth saying it makes him feel sick. The nurses are saying that the dietition will look into it on Monday. They are also saying the doctor is aware of his temperature and thinks his electrolytes are out of wack..they did more blood work today. His mind set was Ok..right up unto yesterday when he told me to call his son and tell him about the cancer, but not to visit. I find it hard to go along with this...and the whole thing is so demanding on me..I am at my wits end. I am currently taking medication to combat this thing. I think if he would allow family members in to see him...I would gain some strength, but as it is now..we are not sure if he will be cured...after the 50/50/ thing. Not sure what to do now.


Carol CG to Husband age 60 Stage IV SCC right tonsil T4AN2B tx rad x 35 chemo x 2 Currently after treatment no sign of cancer in throat. (all clear to date)
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