Finally done with the treatments

Well - yesterday was the last of the treatments - no more radiation or chemo. Finally, Dave can focus on mending. We met with Dr. Sinesi (radiation oncologist) after the final treatment and he thinks that Dave is the first head and neck radiation patient he has had to go through the entire treatment without a break. All of the radiation technicians said the same thing, essentially that Dave is the first that they can remember. So in review - here are some of the factors that helped with our success:
- IMRT: focused the radiation energy at the specific targets, while minimizing the damage to the surrounding tissues.
- Dave's age: young, healthy, etc
- Juven: daily consumption of the nutrition drink. Juven is designed to help in the healing process. Dave started taking this as soon as we started the fitting. Two packets a day, and he is still taking it.
- XClair / Biofine: Dave was and is still religious about putting it on daily - He used the XClair until his neck became too tender / burned - through week 5 to tolerate the application of this semi-thick cream. We are now using the Biofine due to creaminess - very easy to slather on his neck - relieving the burning sensation. The goal is to prevent his skin from drying out as it heals.
- Salagen: This stimulates the production of saliva, and although we don't know what it would be like without it, we really wouldn't want to find out. Dave's mouth is slightly dry, and he is hacking up spit through out the day and night.
- Home mouth rinse: 1 quart water + 1 tsp salt + 1 tsp baking soda. Dave rinses his mouth out continually throughout the day with this. It helps keep his mouth fresh and moist and get's Dave's mouth closer to a normal condition.
- Biotene Mouth rinse: Also a great product that helps out the state of Dave's mouth. It has a minty flavor, so it is a good change and helps to refresh Dave's mouth.


Even though the treatments are done, Dave will still have to deal with the repercussions of the last 10 treatments over the next two weeks. Radiation treatments have about a two week lag time, on the side effects. And Dave finally reached his max pain tolerance yesterday as well, and asked for help. Dr. Sinesi prescribed a liquid form of Vicadin to take when the pain gets too much. Dave took some last night before bed and only woke up a couple of times to hack up a spit ball or two. Dave is looking at only using it when the pain gets too much. Dr. Sinesi also stated that Dave should be back to about 90% by the end of the month. We should start seeing the outside of his neck healing faster than the inside, which just makes sense as it was the last to get sore and unbearable. We should start seeing improvement with his throat in a couple of weeks. In the meantime we are continuing to use the feeding tube and Dave is up to 4 cans of ENSURE Plus a day. I am figuring that we are looking at about three more weeks with the tube, but I know that as soon as Dave can get that tube out he will - great motivation to get the throat healed and back to eating.

Going through this whole process, I am glad that Dr. Sinesi has his feeding tube policy for head and neck patients. It has helped us minimize Dave's weight loss - a total of 14 lbs in the 7 weeks. But realistically speaking, Dave is only down about 6 or so pounds, because he increased his weight prior to the treatment, and his reluctance and stubbornness on the Ensure feedings added to the weight loss. Even though I was right on what he needed nutritionally, he had to hear it from the dietitian for it to be true, valid, or for him to act upon. Oh, well - when you are sick, you don't want to listen to your spouse anyway. He is getting what he needs now, and once he is back up to par, it is back to the gym to build back up his muscles - his arms and legs have become a little skinny over this ordeal.

Thanks again for all the support from everyone.