We are over the hump. Yesterday was the 4th weekly session of chemo (Kytril- anti-nausea and Carboplatin) and radiation session (fractal) #18. Things went smoothly, and the nurse there is really good. Dave is surprised at how little pain he has when she has to stick him for the IV. He grimaces every time she has to find a vein to put the needle in. This time it was his right forearm.
After finishing up with the medical stuff, we headed home and are in the process of getting bids to have a sprinkler system put in around the house. So as Dave was finishing up with the owner of the company I think we are going with, I started dinner - Bubba Burgers with cheese. Now of course David and I are in the dog house for having hamburgers for dinner, but I made an extra one and Dave actually sat down and ended up eating the whole burger with mustard (no bun) and had a small helping of beans. The taste wasn't great, but acceptable. After dinner, Dave had a touch of nausea, so we made sure that he took the anti-nausea pill before bed along with his Salagen.
After a night of tossing and turning, Dave woke up a little nauseated, took his pills again and then got up and headed to the Dodge dealer - 30,000 mile maintenance. He wound up sitting at the dealers for about three hours and had to make a direct trip to the Cancer Treatment Center for his radiation treatment. I ended up meeting him there with his meds and some jello. After his session, we went in and saw Dr. Amin (Dave's other radiation oncologist). He looked in Dave's mouth and noticed that he is getting a slight yeast infection, so he prescribed Nystatin (1tsp four times a day) and then Carafate to help his throat out as well (2tsp three times a day). Both are in liquid form, and must go down his throat. One highlight from talking with Dr. Amin, we might be reduced to 33 sessions vs. 35, but I'm not going to count on it yet.
This afternoon, Dave took it pretty easy while I finished the grout on the fireplace, and as the afternoon wore on he started complaining about more nausea, eventually getting to the point that he thought he was going to vomit. Luckily didn't vomit, but his thick saliva is tickling the back of his throat to the point that he is coughing hard to get it up.
Well things have settled down and it is time to turn in. Still taking it one day at a time - hopefully tomorrow will be better as we finish off week 4. Take care and thanks for the prayers and support.
Thursday, March 15, 2007
Wednesday, March 14, 2007
Morning of the 1/2 way point
Well, here it is Wednesday morning and I thought Dave would up date this. Today marks the 1/2 way point in the radiation treatments. Taking things one day at a time, but I am very glad we are here.
Monday we went to see Dr. Debo (ENT) and he took a good look at Dave's tonsils and throat. All looks good. We talked about his nutrition and weight - he is down 9 lbs since the last visit three weeks ago. Dave's chief complaint is still that food tastes bad, so Dr. Debo reemphasized that the feeding tube would probably be his main means of nourishment, but that he still needs to try to eat - essentially "recreational eating" to keep his mouth (teeth, gums, jaw, tongue, etc) and throat healthy. Dr. Debo also put in a referral for us to see a nutritionalist. After the appointment w/ Dr. Debo, we then went on to the radiation clinic for his daily dose (#16), and I stopped in and talked with Miss Ellie (the Patient Navigator - she works for the American Cancer Society and Chesapeake Hospital) about how to get Dave to understand about his daily nourishment. We have to wait for Tricare to approve the referral for the nutritionalist. She left a message with the local American Cancer Society dietitian to give us a call.
Tuesday - treatment #17, went smoothly - still the chief complaint is sore throat and the taste of food. Had ENSURE plus for every meal and ate two scrambled eggs at lunch. Dave really has no desire to eat anything, primarily because everything taste bad. He even had a hard time getting the Juven down last night.
We talked with a dietitian yesterday, and she gave us some good tips. The main thing is that Dave has essentially given his nourishment over to the feeding tube and Ensure, we are up to 3 bottles of Ensure Plus a day and will probably increase that to 4 here shortly. The key is to keep his weight steady. If he continues to lose weight, increase the number of bottles (one bottle is 8 oz). She gave us some alternatives to mitigate the cost of the Ensure - Walmart's generic "Equate" is comprable, I just have to make sure that I get the "Plus" form (350 cal), and our local VA hospital has a cantena and she think we can get the Ensure there for less as well. Other notes:
- nothing thicker than the Ensure down the feeding tube
- don't force the 8 oz of ensure in at once - slow down and take it in over 10 or so minutes
- keep up on the fluids - 6-8 cups a day (we are doing pretty good on this one)
- try lemon/lime or lemonade in water to make it taste better
- Dave is having a hard time swallowing the multi-vitamin - switch to children's chewable (2 a day)
- if constipation becomes a problem (since he is essentially on a liquid diet) talk to our nurse about daily fiber or other options.
The bottom line is to keep experimenting to find something that tastes decent for Dave to eat, stick with the Ensure to maintain Dave's weight, and keep the fluid level up as well.
Hopefully Dave will update this later today - take care and thanks again - Marjie
Monday we went to see Dr. Debo (ENT) and he took a good look at Dave's tonsils and throat. All looks good. We talked about his nutrition and weight - he is down 9 lbs since the last visit three weeks ago. Dave's chief complaint is still that food tastes bad, so Dr. Debo reemphasized that the feeding tube would probably be his main means of nourishment, but that he still needs to try to eat - essentially "recreational eating" to keep his mouth (teeth, gums, jaw, tongue, etc) and throat healthy. Dr. Debo also put in a referral for us to see a nutritionalist. After the appointment w/ Dr. Debo, we then went on to the radiation clinic for his daily dose (#16), and I stopped in and talked with Miss Ellie (the Patient Navigator - she works for the American Cancer Society and Chesapeake Hospital) about how to get Dave to understand about his daily nourishment. We have to wait for Tricare to approve the referral for the nutritionalist. She left a message with the local American Cancer Society dietitian to give us a call.
Tuesday - treatment #17, went smoothly - still the chief complaint is sore throat and the taste of food. Had ENSURE plus for every meal and ate two scrambled eggs at lunch. Dave really has no desire to eat anything, primarily because everything taste bad. He even had a hard time getting the Juven down last night.
We talked with a dietitian yesterday, and she gave us some good tips. The main thing is that Dave has essentially given his nourishment over to the feeding tube and Ensure, we are up to 3 bottles of Ensure Plus a day and will probably increase that to 4 here shortly. The key is to keep his weight steady. If he continues to lose weight, increase the number of bottles (one bottle is 8 oz). She gave us some alternatives to mitigate the cost of the Ensure - Walmart's generic "Equate" is comprable, I just have to make sure that I get the "Plus" form (350 cal), and our local VA hospital has a cantena and she think we can get the Ensure there for less as well. Other notes:
- nothing thicker than the Ensure down the feeding tube
- don't force the 8 oz of ensure in at once - slow down and take it in over 10 or so minutes
- keep up on the fluids - 6-8 cups a day (we are doing pretty good on this one)
- try lemon/lime or lemonade in water to make it taste better
- Dave is having a hard time swallowing the multi-vitamin - switch to children's chewable (2 a day)
- if constipation becomes a problem (since he is essentially on a liquid diet) talk to our nurse about daily fiber or other options.
The bottom line is to keep experimenting to find something that tastes decent for Dave to eat, stick with the Ensure to maintain Dave's weight, and keep the fluid level up as well.
Hopefully Dave will update this later today - take care and thanks again - Marjie
Sunday, March 11, 2007
Done with Week 3 - On to Week 4
Well, here it is Sunday, and I noticed that Dave hasn't updated this in a couple of days. He is finally through the third week - 15 fractals down, 20 left. I think he is doing fairly well, actually better than we expected. Here are a couple of pictures:
As you can tell, his hair is starting to grow back. It is baby fine - peach fuzz, both on the top of his head and his chin.
Hi neck is looking good as well. He has been very good at putting the X-Clair cream on three times a day. We've got the Juven drinks down to a routine now - Orange in the AM, Grape in the PM. The hardest part of his meds is remembering to take the Salagen 4 times a day...we've been good at three times, but if I don't remind him, he doesn't take them.
The remaining hurdle is getting him to eat enough. Although on the outside he looks really good, he is hurting on the inside. The combination of the sore throat (which actually subsided a little on Friday and Saturday) and the loss of his sense of taste, makes eating difficult. So we are on the constant battle of consuming enough. My goal is for him to get at least 1500 calories a day - preferably more. Dave and I have come to the agreement that if he doesn't get at least 500 calories at a meal, then he need to drink an Ensure, or other meal- replacement drink. He is not exactly thrilled with the taste of Ensure, and thus the battle ensues. I have been on the pursuit of a nutritious, good tasting milkshake (one that I can pack the calories in that he will not turn his nose up at, since he has been reluctant to use the feeding tube for anything other than water. Yesterday we hit a milestone. After Dave was not able to eat much of a very good steak dinner last night, our good friend from WA, Tami Branch helped me convince Dave to try the feeding tube with the Ensure. Tami was in town going to school for the week and came over and spent the day with us. It was really nice to catching up on all the news in Port Orchard and having Dave hear another perspective on nutrition - other than mine. So he downed a bottle of room temperature Ensure Plus (350 cals) using the tube with really no difficulty. Hooray!
Well tomorrow starts week 4 with fractal 16 - Wednesday we will be at the half-way point. Although I am just here on the sidelines, helping Dave get through this, I will be glad when we are done, and I have my hard charging husband back. It is hard watching someone you love be in pain, and not be able to fix it - He is doing really well at staying positive and busy - reloading, spending time at the gun range with David, helping me paint the inside of the house, and our latest project - replacing the tile around the fireplace. He also just got a new digital camera (CANON Rebel XT), and ordered me a GPS for my car...some good gadgets to keep him occupied while I am at work. Speaking of work - my Humanitarian transfer did go through and I am now on shore duty, and the command is giving me all the time off I need to take care of Dave. It is what I need, but I will say that going from a very high stress - fast pace job focused on schedules and operations, to the calm and almost 100% focus at home is an adjustment for me. Lucky for me, my command knows where my focus has to be (Dave), and although I feel somewhat guilty not contributing to the command, my focus is at home for the next couple of months until he is through this, then I can go back to the working world, and then to back to sea duty again.
So I think I have written enough...Dave is doing well, and the support that all of you have been given us is nothing short of outstanding. Thank you for all the comments, emails, cards, wishes, and prayers. We are taking this one day at a time...and soon enough this will be all over and we will be back out there enjoying life.
Just notes ~
Side effects: sore throat, thick spit, everything taste horrible, mouth hurts
Meds: Salagen (dry mouth), X-Clair (skin), Prilosec (tummy), Prochlorperazine (anti-nausea), Multi-vitamin, Clack's VOA (for sore throat and mouth - not that I can get him to use it).
Chemo: Carboplatin
Products: Juven (Therapeutic Nutritional Drink), Biotene Mouthwash(non-alcohol mouthwash - really good), Home made mouth rinse (1qt water+1t baking soda + 1t salt), Ensure.
Weight: 163.
Take care and thanks again for all the love and support - Marjie
As you can tell, his hair is starting to grow back. It is baby fine - peach fuzz, both on the top of his head and his chin.
Hi neck is looking good as well. He has been very good at putting the X-Clair cream on three times a day. We've got the Juven drinks down to a routine now - Orange in the AM, Grape in the PM. The hardest part of his meds is remembering to take the Salagen 4 times a day...we've been good at three times, but if I don't remind him, he doesn't take them.
The remaining hurdle is getting him to eat enough. Although on the outside he looks really good, he is hurting on the inside. The combination of the sore throat (which actually subsided a little on Friday and Saturday) and the loss of his sense of taste, makes eating difficult. So we are on the constant battle of consuming enough. My goal is for him to get at least 1500 calories a day - preferably more. Dave and I have come to the agreement that if he doesn't get at least 500 calories at a meal, then he need to drink an Ensure, or other meal- replacement drink. He is not exactly thrilled with the taste of Ensure, and thus the battle ensues. I have been on the pursuit of a nutritious, good tasting milkshake (one that I can pack the calories in that he will not turn his nose up at, since he has been reluctant to use the feeding tube for anything other than water. Yesterday we hit a milestone. After Dave was not able to eat much of a very good steak dinner last night, our good friend from WA, Tami Branch helped me convince Dave to try the feeding tube with the Ensure. Tami was in town going to school for the week and came over and spent the day with us. It was really nice to catching up on all the news in Port Orchard and having Dave hear another perspective on nutrition - other than mine. So he downed a bottle of room temperature Ensure Plus (350 cals) using the tube with really no difficulty. Hooray!
Well tomorrow starts week 4 with fractal 16 - Wednesday we will be at the half-way point. Although I am just here on the sidelines, helping Dave get through this, I will be glad when we are done, and I have my hard charging husband back. It is hard watching someone you love be in pain, and not be able to fix it - He is doing really well at staying positive and busy - reloading, spending time at the gun range with David, helping me paint the inside of the house, and our latest project - replacing the tile around the fireplace. He also just got a new digital camera (CANON Rebel XT), and ordered me a GPS for my car...some good gadgets to keep him occupied while I am at work. Speaking of work - my Humanitarian transfer did go through and I am now on shore duty, and the command is giving me all the time off I need to take care of Dave. It is what I need, but I will say that going from a very high stress - fast pace job focused on schedules and operations, to the calm and almost 100% focus at home is an adjustment for me. Lucky for me, my command knows where my focus has to be (Dave), and although I feel somewhat guilty not contributing to the command, my focus is at home for the next couple of months until he is through this, then I can go back to the working world, and then to back to sea duty again.
So I think I have written enough...Dave is doing well, and the support that all of you have been given us is nothing short of outstanding. Thank you for all the comments, emails, cards, wishes, and prayers. We are taking this one day at a time...and soon enough this will be all over and we will be back out there enjoying life.
Just notes ~
Side effects: sore throat, thick spit, everything taste horrible, mouth hurts
Meds: Salagen (dry mouth), X-Clair (skin), Prilosec (tummy), Prochlorperazine (anti-nausea), Multi-vitamin, Clack's VOA (for sore throat and mouth - not that I can get him to use it).
Chemo: Carboplatin
Products: Juven (Therapeutic Nutritional Drink), Biotene Mouthwash(non-alcohol mouthwash - really good), Home made mouth rinse (1qt water+1t baking soda + 1t salt), Ensure.
Weight: 163.
Take care and thanks again for all the love and support - Marjie
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