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#47031 07-28-2006 10:43 AM
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Well, I've just reached week 4 of the 7 radiation treatments and am still able to eat by mouth (soft, smooth foods like Jevity, Ensure, puddings, cream soups, yogurt (lowest acid ones) and frozen yogurt. I was told yesterday that the side effects from radiation should have plateaued, meaning that the effects I'm currently having will continue, no better, no worse, until I'm finished with the 7 weeks, then will start the healing process.

If that's true (and I pray it is!), I won't have needed this PEG stomach tube (first OR second ones) at all. All that pain and fear twice, but I'm glad I had it installed just in case.

Guess I can put up with it for another 2 months, but as soon as I'm able to include chunkier foods (soft fish, meats, veggies), I'm having the sucker removed ASAP.

In the meantime, I don't know if it's just my tube or not, but the dumb thing tends to ooze stomach contents out the feeding end. And it smells like vomit and smelly feet no matter how often I clean and flush it, not a happy smell! So I bought some of those thin panty liners for female hygiene, the ones with the sticky backs. Put the tube end on half of the sticky back and just fold and press the other half over it. Cuts the smell WAY down, plus is more comfortable against the skin because of the soft cotton covering.

Hope this suggestion helps someone else that might have run into this problem.

On the plus side, the first tube that was removed healed in nothing flat, just leaving a red dimple right under my ribs. That I can live with. But no leakage or infection at all from it.

Sharon

#47032 07-28-2006 02:43 PM
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Sharon,

I don't know who told you that the radiation effects would plateau in week 4 of 7, but it sounds like someone who has never actually experienced radiation. I can't recall a single poster on this site who has reached a "plateau" in side effects midway through treatment, so I'm concerned that you may have gotten some misleading information. Personally I found the first few weeks to be pretty tolerable, and I was eating about the same things you are, but the remaining weeks of treatment (and several weeks after that) got much worse in terms of pain, thrush, and eating difficulties.

While I was able to get through without a PEG tube, eating became an increasing struggle in the last several weeks of radiation and for a couple of months after that. Since you have the tube available, you may find that you want to make use of it at some point.

Cathy


Tongue SCC (T2M0N0), poorly differentiated, diagnosed 3/89, partial glossectomy and neck dissection 4/89, radiation from early June to late August 1989
#47033 07-28-2006 02:50 PM
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Hi, Sharon- just wanted to let you know that John's tube also has liquids back up into it. He finishes each feeding with an 8 oz flush of water to keep it clean. He uses peroxide around the incision if it starts getting yucky looking and always wears a gauze pad next to his skin. Amy


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

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#47034 07-28-2006 04:49 PM
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Hi SharonD:

I posted something in reply to you under "currently under treatment." Sounds like you're doing very well, but as mentioned, be prepared for things to get worse, and well beforehand, request the proper pain manangement such as Fentanyl patch and liquid morphine for breakthrough pain! I can't stress this enough. My husband suffered horribly during his last week of treatment because his pain was not managed correctly.

I will pray for you!


Husband Dx 4/06, Stg IVa, T1N2aM0, primary lft tonsil, treatments to begin 5/28/06.
#47035 07-28-2006 06:16 PM
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Like Cathy, I did really well the first few weeks of treatment. Shoot, I was a little cocky about it all! Then the side effects kicked in and I was miserable. Sharon, like Cathy I have never heard of anyone being told that the side effects peaked at 4 weeks. That simply isn't true. If anything, the WORST two weeks are the two weeks AFTER the last treatment, as the effects of radiation are accumulative and are STILL at work. Again, I hope your good luck continues but don't want any newcomers mislead by your very unusual circumstances.


SCC Left Mandible. Jaw replaced with bone from leg. Neck disection, 37 radiation treatments. Recurrence 8-28-07, stage 2, tongue. One third of tongue removed 10-4-07. 5-23-08 chemo started for tumor behind swallowing passage, Our good friend and much loved OCF member Minnie has been lost to the disease (RIP 10-29-08). We will all miss her greatly.
#47036 07-28-2006 08:48 PM
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My whole treatment lasted for 7 weeks and I remember the side effects started getting worse when I was in week 5 when my neck was burnt and swallowing had become a big problem. I even suffered from high fever and was finally admitted to hospital for 3 weeks.I am not sure at what time I faced the worst situation but I agree with Minniea that side effects are accumulative and can be working even after a few years of remission. That may sound scary but people who have intensive radiation are likely to experience this. Yet, I also believe that everyone's experience is unique and some can be luckier than others. We are here to share our own experience and it is important that when reading the posts here, members understand that what apply to others may not necessarily apply to them. For instance, some think that inserting a PEG is a walk in the park but some may think the opposite. I won't comment here as I never had one.

Karen


Karen stage 4B (T3N3M0)tonsil cancer diagnosed in 9/2001.Concurrent chemo-radiation treatment ( XRT x 48 /Cisplatin x 4) ended in 12/01. Have been in remission ever since.
#47037 07-29-2006 01:13 AM
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I just need to chime in that week 4 was far from the peak of side effects from radaition for me. For me they peaked about two weeks after the end of radiation.

I also had a PEG that I wasn't using into week 4 and I think one thing you need to be aware of is that even when you aren't using your PEG, you do need to flush it at least once a day because yes, the contents of what's in your stomach will back up into it. Flush it with somethinhg fizzy and nice-smelling is my advice. I used gingerale for a while. Much better than sticking some artifically scneted pad over the top--god knows what chemicals are in that that ccould go back down into your stomach!

Nelie


SCC(T2N0M0) part.glossectomy & neck dissect 2/9/05 & 2/25/05.33 IMRT(66 Gy),2 Cisplatin ended 06/03/05.Stage I breast cancer treated 2/05-11/05.Surgery to remove esophageal stricture 07/06, still having dilatations to keep esophagus open.Dysphagia. "When you're going through hell, keep going"
#47038 07-29-2006 11:25 AM
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Sharon, If your peg tube is one of the types that has a "whip" end (extends away from the body) you should be using a rubber band on it. Fold the thing in half, and then in half again, and put a rubber band around the bundle. The kink nearest your body will prevent Anything from coming through it, and the bundle of tubing is a bit easier to tape down.

At one point, when I was still using whip type peg tubes, I slid a paper clip over the tube near my body to pinch it shut. I wore a simple string lanyard around my neck, that hung low enough to hold onto the top of the tube and keep in vertical under my shirt.

Get creative with pinching the tube shut. Tiny clothes pin, paper clip, bobby pin, crimped and rubber banded, crimped and tied with a shoe string. Make certain your clamp pinches tight enough to completely close the tube, but not so tight that it cuts into the tubing.

Only docs who have never worn a peg tube continue to install tubes with whips. The real pros install the MicKey type tubes that are flat on your stomach and have no whip. The head of the peg has a valve and fitting. A whip with a special end is inserted and twisted into the peg when feeding, and then removed. No tubing, no leakage - very nice. Some of us live by our pegs and have learned many of the lessons the hard way. Be strong. Tom J


SCC BOT, mets to neck, T4.
From 3/03: 10wks daily multi-drug chemo,
Then daily chemo with twice daily IMRT for 12 weeks - week on, week off. No surgery. New lung primary 12/07. Searching out tx options.
#47039 07-29-2006 01:12 PM
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I have a peg question as well. In addition to the problems that Sharon is also having, I am still having a lot of pain where the peg was insterted two weeks ago. Is this normal. I would give it a 7-8 without painkillers on a scale of 10.

Sarah


DX on 05/01/06 with SCC of right tongue. 05/11/06 surgery-tumor 1.2cm & 4 cm clear margins & parital glos. & neck dissection with removal of 34 nodes/1 positive at 4mm)T1N1MO
35 IGRT & 3 cycles of chemo (1 cisplatin & 2 carbo-complete on 8/9/06.
#47040 07-29-2006 04:31 PM
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Sarah, call the Doc who inserted your tube and tell him that you are having that pain. If he tells you it will subside in 4 or 5 days, o.k.- but you need to tell him that IF it doesn't go away, you want to come see him. Amy


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

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#47041 07-30-2006 03:52 AM
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That's a lot more pain than I had two weeks after. It was very painful for the firts 4-5 days but after that it got better pretty rapidly.


SCC(T2N0M0) part.glossectomy & neck dissect 2/9/05 & 2/25/05.33 IMRT(66 Gy),2 Cisplatin ended 06/03/05.Stage I breast cancer treated 2/05-11/05.Surgery to remove esophageal stricture 07/06, still having dilatations to keep esophagus open.Dysphagia. "When you're going through hell, keep going"
#47042 07-30-2006 07:02 AM
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I have an appointment on Wednesday for them to look at it including inserting some dye and x-raying me to see if it working properly.


DX on 05/01/06 with SCC of right tongue. 05/11/06 surgery-tumor 1.2cm & 4 cm clear margins & parital glos. & neck dissection with removal of 34 nodes/1 positive at 4mm)T1N1MO
35 IGRT & 3 cycles of chemo (1 cisplatin & 2 carbo-complete on 8/9/06.
#47043 07-30-2006 11:41 AM
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If it is standard clear vinyl tubing you should be able to get clamps to shut it off

Try http://www.tapplastics.com/shop/product.php?pid=146


Gary Allsebrook
***********************************
Dx 11/22/02, SCC, 6 x 3 cm Polypoid tumor, rt tonsil, Stage III/IVA, T3N0M0 G1/2
Tx 1/28/03 - 3/19/03, Cisplatin ct x2, IMRT, bilateral, with boost, x35(69.96Gy)
________________________________________________________
"You are a mist that appears for a little while and then vanishes" (James 4:14 NIV)
#47044 07-31-2006 04:46 AM
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Mine has a clamp. The problem is that 3 hours after I have poured 1 can of Boost in the tube, I go to unclamp it and about 1/4 of the prior can runs out. It doesn't seem that it should take that long for me to digest one can of Boost-should it?


DX on 05/01/06 with SCC of right tongue. 05/11/06 surgery-tumor 1.2cm & 4 cm clear margins & parital glos. & neck dissection with removal of 34 nodes/1 positive at 4mm)T1N1MO
35 IGRT & 3 cycles of chemo (1 cisplatin & 2 carbo-complete on 8/9/06.
#47045 07-31-2006 11:42 AM
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I am somewhat of a professional in respect tp Peg tubes, since I have had one since initial treatments and will have one for the remainder of days here on this planet. I am one of those unlucky individuals with a radiation damaged epiglotis, I cannot even take a sip of water by mouth due to aspiration. I now have a foley type G-tube that cannot be clamped off like a PEG. I have a lopez valve on top to keep the contents of my stomach from spilling. I stiil have accidents due to my ignorance and they are messy.
Darrell


Stage 3, T3,N1,M0,SCC, Base of Tongue. No Surgery, Radiationx39, Chemo, Taxol & Carboplatin Weekly 8 Treatments 2004. Age 60. Recurrence 2/06, SCC, Chest & Neck (Sub clavean), Remission 8/06. Recurrence SCC 12/10/06 Chest.
#47046 07-31-2006 03:36 PM
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Gee, Sarah, like I posted earlier, John always has a little residual in his tube, but if 1\4th of a can of Boost came back up, we would be worried too. Hope someone can fix this for you. eek Amy


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

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#47047 08-01-2006 10:02 AM
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If I remember correctly, if I took the clamp off mine without connecting the tube to the syringe everthing would pour out (only did it a few times made such a mess) Is this what is happening to you? If so just remember to keep the clamp on till you are connected up!
Hope this helps
Sunshine.. love and hugs
Helen


SCC Base of tongue, (TISN0M0) laser surgery, 10/01 and 05/03 no clear margins. Radial free flap graft to tonsil pillar, partial glossectomy, left neck dissection 08/04
#47048 08-10-2006 06:12 PM
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Fellow peggers - Nothing should spill from your peg when you open it. If the peg is properly installed and is operating properly, nothing should come pouring out. Are you eating in a reclined postition? You should be. Lean back, elevate your feet, relax your abdomen before you open the tube.

If you are standing, or sitting vertical, the inside end of your tube is "under water" (or worse). Peggers don't eat vertically at the table, peggers eat reclined in the Lazy Boy.

For the visual among us: Take a large zip lock bag and color a big, quarter-sized dot in the middle of the bag. Fill the bag half full of water. Blow it full of air and zip it shut. Thats your stomach and the dot is your peg. You gotta LEAN that bag back till the dot is at the top of the air pocket.

To complete this physics lesson, cut out the dot, and carefully lift the bag with both hands. Now, simulate a sneeze (viscously grip the bag with both hands and squeeze hard). I have compelted this maneuver with my peg - while pouring in strawberry ensure. The sneeze brought forth a lovely pink geyser that took nearly two hours to clean up. The moral..... opened peg tubes should belch, not pee. Be strong, Tom


SCC BOT, mets to neck, T4.
From 3/03: 10wks daily multi-drug chemo,
Then daily chemo with twice daily IMRT for 12 weeks - week on, week off. No surgery. New lung primary 12/07. Searching out tx options.
#47049 08-10-2006 06:28 PM
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I may have to respectfully disagree with you on this one Tom. I had a PEG for 9 months and never had an ounce of trouble with it, so it was obviously installed properly. If I was sitting in a chair or standing and I opened the end, the amount and time I had "eaten" last would determine if anything came out. If I were lying flat, usually nothing would come out even if I had just eaten. I never reclined to use the tube, I did it wherever I was at the time. In the car, cooking dinner in the kitchen, on the computer, etc. I plugged in the syringe, poured the food in the syringe and waited for it to go in. It got so I could put a can in my tube in under 5 minutes. I'm not suggesting this style to anyone, I hate to sit still so do most things on the go. But, I don't want everyone whose tube may leak to worry or wonder if it's installed properly.
Take care,
Minnie


SCC Left Mandible. Jaw replaced with bone from leg. Neck disection, 37 radiation treatments. Recurrence 8-28-07, stage 2, tongue. One third of tongue removed 10-4-07. 5-23-08 chemo started for tumor behind swallowing passage, Our good friend and much loved OCF member Minnie has been lost to the disease (RIP 10-29-08). We will all miss her greatly.
#47050 08-10-2006 07:09 PM
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I will vote with Minnie on this. I found it was more comfortable to sit upright to feed. I had mine for 6 months and never had any trouble at all. I hung the gravity feed pouches on an IV stand, which I then set on a table while I sat on the floor to get it to go in faster. I could do it in about 5 minutes also. Which proves once again that everyone's treatment reactions, and PEG installations, are different.

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