Dave has had a miserable few days. His neck is extremely sore and tight, to the point that he doesn't want to turn his neck or even talk. Wednesday and Thursday he was able to get some sleep, with the help of the pain medicine. I actually got a fairly good night sleep on Thursday as well. Dave still has the extremely thick spit, which he is hacking up on a fairly regular basis, and in the morning, he has been racked with dry heaves trying to get the mucous out of the back of his throat, which of course just wear him down.
The skin on Dave's neck seems to be drying out. Pretty much as your skin would after an intense sunburn - the outer layer gets tough and eventually peels off. Dave is entering that stage, but as his skin cracks off - the skin underneath is very raw, tender, and painful. A perfect example of that is when Dave gets out of the shower, his neck is extremely painful until we get the cream (Biofine) on his skin, and although he cringes through the application, it does provide relief, by cutting through the sting and softening up his skin.
Everything is still going in through the tube. He's pretty good about getting the stuff in, it is just getting enough of the stuff in. At a minimum he is getting 3 cans of ENSURE Plus, 2 pks (12oz) of Juven, and all his meds, it is that 4th can of ENSURE Plus that may or may not get done. As always, attitude is everything, and of course, when he doesn't want to do something, he can be stubborn about it, especially when he is in pain.
David and I are continuing on with everything else. David decided on staying close to home for college and is going to attend Old Dominion University in Norfolk. Prom is right around the corner in May, so he is working on his plans for that, then we have his graduation in June. I can't believe my baby is grown up. Other than that, we are still working on the yard (garden, flowers, lawn) and the house (painting and minor repairs). It is kind of like when Dave was on deployment last, only this time he is here and pretty vocal about his opinions. Well we are pushing on as always, and will be very glad when Dave is back on his feet again. Thanks for all the support, love, comments, prayers, cards and gifts, they have been so very helpful through this entire ordeal. Thank you again.
Saturday, April 7, 2007
Thursday, April 5, 2007
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.
- 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.
Tuesday, April 3, 2007
Finally - down to only one treatment left.
Well here it is Tuesday evening, and we are looking at the last radiation and chemo treatment tomorrow. And the bottom line is that Dave is miserable. He is trying not to talk, his neck is extremely sore - inside and out -, and he desperately wants to feel better. Tomorrow we will see Dr. Sinesi (radiation oncologist) and I think the biggest concern that I have is the fact that Dave is unable to swallow or get anything down his throat.
We got a call from the American Cancer Society nutritionist today, and since Dave is down about 7 pounds since we talked to her a month ago, she wants us to increase the Ensure to at least 4 cans per day - preferably 5. Dave is taking on three right now. Other than that he is doing pretty good on keeping his fluid consumption up and he is still trying to walk and move about to keep his body somewhat active and his muscles engaged.
Speaking of muscles engaged - I think some of the problem with Dave being unable to swallow is that was getting into the habit of not swallowing unless absolutely necessary (the 4 times a day needed to take his pills) , primarily due to the fact that his throat really hurt - swallowing razor blades is how he described it. Like I said we will see the doctor tomorrow and we'll have a better idea of what is going on with that. We also have an appoint with his gastronomical doctor next week, so there is another avenue for thoughts. But as it is right now - everything is crushed up and fed through the tube - Dave is very proficient at feeding himself with the tube - pretty much he puts something in the tube every two hours or so.
Other areas is that the sprinkler system is now in and it is now up to me to get our yard in order. With all the work that we had done over the past couple of months, the yard is not looking like the typical Vigal yard - just a lot of dirt among the grass, no flowers, weeds, and the sprinkler system left some high spots in the yard. So David and I have our work cut out for us, time to get the mower out, visit the local nursery, and get our hands dirty.
Well I've bounced around to a lot of topics. We are surviving this, nerves have been stretched, tempers have flared, and alternatives and comprises abound. Each day is different and each struggle only makes us stronger - I will be so glad when all of this is in the rear view mirror. Thanks for all the support.
We got a call from the American Cancer Society nutritionist today, and since Dave is down about 7 pounds since we talked to her a month ago, she wants us to increase the Ensure to at least 4 cans per day - preferably 5. Dave is taking on three right now. Other than that he is doing pretty good on keeping his fluid consumption up and he is still trying to walk and move about to keep his body somewhat active and his muscles engaged.
Speaking of muscles engaged - I think some of the problem with Dave being unable to swallow is that was getting into the habit of not swallowing unless absolutely necessary (the 4 times a day needed to take his pills) , primarily due to the fact that his throat really hurt - swallowing razor blades is how he described it. Like I said we will see the doctor tomorrow and we'll have a better idea of what is going on with that. We also have an appoint with his gastronomical doctor next week, so there is another avenue for thoughts. But as it is right now - everything is crushed up and fed through the tube - Dave is very proficient at feeding himself with the tube - pretty much he puts something in the tube every two hours or so.
Other areas is that the sprinkler system is now in and it is now up to me to get our yard in order. With all the work that we had done over the past couple of months, the yard is not looking like the typical Vigal yard - just a lot of dirt among the grass, no flowers, weeds, and the sprinkler system left some high spots in the yard. So David and I have our work cut out for us, time to get the mower out, visit the local nursery, and get our hands dirty.
Well I've bounced around to a lot of topics. We are surviving this, nerves have been stretched, tempers have flared, and alternatives and comprises abound. Each day is different and each struggle only makes us stronger - I will be so glad when all of this is in the rear view mirror. Thanks for all the support.
Sunday, April 1, 2007
Starting the final week of radiation - 3 sessions left
Well it is Sunday and Dave has 30 sessions under his belt - 3 to go. Dave has been trying to do stuff around the house when he has the energy. Since Wednesday, we have had a local company out putting in a sprinkler system in our yard. Dave has been very diligent about watching them work and keeping himself out of the sun. The contractor is almost done - they'll be out on Monday to finish up, but our driveway was covered with dirt. So after they stopped yesterday, Dave and I got the power washer out and washed the back patio, front porch, walk, and driveway. We would alternate with the power washer and I had fun moving our sun umbrella around the driveway to keep Dave out of the sun while he washed.
The unfortunate side is that the side affects are getting worse by the day. His neck is extremely red, sore, and 1st and 2nd degree burns which makes it difficult for him to move his neck. For the most part his neck is a deep brown red (looks like a deep tan with a sun burn), there are numerous areas that are starting to blister up.
And the back of his neck has peeled as well. We are being very diligent about putting the cream on it. Dave is using the Biofine as it goes on easier than the XClair. We are also putting aloe on his neck as well. He has also switched to wearing tank tops to ensure nothing rubs on his neck.
His throat continues to be extremely sore, and he has been having a really hard time swallowing. Up until yesterday evening Dave has been able to swallow his Salagen pill. This morning it seemed to get caught 1/2 way down and his body decided to try to bring it back up and he spent a few minutes dry heaving with nothing coming up. He was extremely spent after the ordeal. So we switched to crushing it up as well and sending it through the tube.
His spit continues to be thick, and varies in color from clear/white to yellow and occasionally will be tinged with blood. I am trying not to cringe when he hacks and gags trying to get the spit out of the back of his throat. The strain is taking it's toll on Dave. He has pretty much spent the day on the couch - with not much energy or desire to do anything. We maybe went overboard yesterday with the power washer.
Overall - we'll be glad when this is done, and of course the sooner the better. All the comments, cards, emails, prayers and wishes are greatly appreciated. Thanks for all the support - we will be through this soon.
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