gastric feed tube

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Hello 

Everyone

I have a diagnosis of Squamous cell carcinoma of left tonsil, P16 positive, T2 NT M0. I am into my fourth week of proton therapy. I have grade 3 mucositis and eating soft food is becoming excruciating. Also had a recent spike in temperature of 38.7 resulting in admission for screening for sepsis. I was concluded that infection was present, thrush and possible throat infection with prescription of two types of antibiotics. I am on morphine solution and paracetamol and have been commenced on fentanyl patches two days ago with some notable improvements. Weight loss continues and think I have lost another 2kg this week. I am planning to see key worker tomorrow and explain that even soft foods, soups and things like this are hard to get down with high levels of stinging and burning pain.

I know there is a lot of people out there with immense knowledge and experience and was curious to know at what point is it to consider have a gastric nasal tube fitted. Are there advantages of persevering for a little while longer to give infection to clear and the fentanyl to kick. Your views will be kindly appreciated.

Much Thanks Shaun          

  • Hi Shaun towards the end of week 3 I had my n g tube fitted I couldn’t swallow any soft foods not even the ensure drinks. I could sip water but not enough to get by on. For me it was a lifesaver. It enabled me to start eating again week 3 of recovery as I dudnt have ti stress about getting enough calories in. I was loosing weight so it was a no brainer for

    me. i Aldi got oral thrush only flucozonole shifted it. 
    Hazel 

    Hazel aka RadioactiveRaz 

    My blog is www.radioactiveraz.wordpress.com  HPV 16+ tonsil cancer Now  6 years  post treatment. 35 radiotherapy 2 chemo T2N2NM.Happily getting on with living always happy to help

    2 videos I’ve been involved with raising awareness of HNC and HPV cancers 

    https://www.instagram.com/merckhealthcare/reel/DBs8Y0niJ8N/

  • Cheers Hazal 

    Thats helpful and yes, I am on the flucozonale. I think after this week I will probably have the g tube fitted as like you even the ensure drinks are getting challenging with getting down and induce an eye watering burning and stinging. Treatment is bloody tough, but I keep focusing on an eventual end point and planning to get out on my trail and road bike (more miles more smiles). I was lucky to get to Spain -Puerto pollensia for 5 days cycling. Hoping to get out as soon as I can for my, recovery steady away though initially.This is a great sight full of lovely folk and I must say each time I interact on it with people it does bolster my mood, so thanks folk for this. 

    Cheers Hazal    

  • Hi Shaun it’s good  to have aims. My aim was 8 weeks after to get on a plane over to Murcia for hubby’s 60 th I did and I rode my bike only 8  km but I did it. We’re over in Murcia as I type yesterday biked  50 km not  electric I may add ours pedal power. We bike most days. Not bad for a 65 year old. I do think the n g tube helped me to recover as I wasn’t fighting food  all my water. Medication and  feed went in via it. It left me free to sip and keep my swallow going without having to force food in. 
    You’re welcome can’t beat  first hand experience.

    Hazel  

    Hazel aka RadioactiveRaz 

    My blog is www.radioactiveraz.wordpress.com  HPV 16+ tonsil cancer Now  6 years  post treatment. 35 radiotherapy 2 chemo T2N2NM.Happily getting on with living always happy to help

    2 videos I’ve been involved with raising awareness of HNC and HPV cancers 

    https://www.instagram.com/merckhealthcare/reel/DBs8Y0niJ8N/

  • Hi Hazel 

    Well done with the cycling. It's a great for physical and mental health. Just been talking to my wife and we are going to think about a nice holiday in the sun once things allow. your views about the the g tube make sound sense and I will discuss tomorrow with my key worker as the joys of eating have gone about a week ago and now it's a painful ordeal. I agree optimum nutrition will aid consolidation of treatment and put me in good stead for recovery.

    Cheers again Hazal and happy pedalling.     

  • curious to know at what point is it to consider have a gastric nasal tube fitted

    When eating is impossible. Is there any point in making my every minute excruciatingly painful slogging through food to keep me alive ? is what I thought 

    I had an NG tube in week 4 and it saved my life. I was told at the beginning of treatment that I would have it when needed. I still remember my consultants face ( good job we share a sense of humour) when having told him I would try to get through without one, he grinned at me and said he would really fry my throat so it was unlikely. There was never a moment when I debated to myself whether I could last a little longer without one. 
    My advice would be don’t suffer, do it. Get better sooner. 

    Dani 

    Base of tongue cancer. T2N0M0 6 weeks Radiotherapy finished January 2019

    I BLOGGED MY TREATMENT 

    Macmillan Support Line -  0808 808 00 00 7 days a week between 8am-8pm

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  • Good evening Shaun, i totally agree with Dani , thankfully i had a PEG feeding tube fitted from day one, its great to see you are trying to eat but if you are losing weight and suffering from pain i would suggest you have the NG tube fitted A.S.A.P this would help both your recovery and putting some weight back on. I myself have been on fentanyl patches so i understand the pain you are going through. I hope you get the feeding tube fitted so you can continue with a less stressful recovery. Wishing you all the best, take care.

                                                                                               Chris 

    Its sometimes not easy but its worth it ! 

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  • Hi Shaun, like many on this site I was initially resistant to a feeding tube, I was persuaded by my consultant and had a PEG fitted in my first week of treatment. It was a life saver. At week 3 I was eating normally , by week 4 I was too sick to eat and the sickness continued until two weeks after treatment stopped (radiotherapy and chemotherapy). I’m currently waiting for the PEG to be removed (9 weeks post recovery) but I would seriously recommend having the nasal tube fitted, it takes away the stress of eating and I think for many of us with this type of cancer, the whole thing around food and weight loss becomes quite an issue and it’s one less thing to worry about. Good luck with it all. 

    Debbie x

  • Hi Sean,

    I'm going to be having a NG Tube fitted soon, as i've lost a lot of weight. It's to help me before and during my Radiotherapy which will be starting in the near future. I wasn't going to turn it down,

    Having cancer is a big enough battle on it's own, so don't struggle with pain when you don't have to.

    Good luck 

  • Hi Everyone 

    Thanks for the valuable advice. Had a discussion with oncologist and advised pain medication, pregabalin, morphine and fentanyl to be increased and potential for NG tube next week after my chemo on Monday.

    Also said I am doing well, but he did not want to alarm me and advised that the ulcers will progress, and pain will increase as the treatment goes on.

    I Think I have made my mind up in that I will insist that arrangements are made for NG tube after next Monday. In the mean- time focusing upon getting the fortisip down. 

    Thanks for the advice again, folks.  

    All the Best Shaun 

  • Hello again !

     I tried the Fortisip and hated them !! so they tried me on the Fortijuce instead, they are better, but still only like the Apple one.

    So if your not liking the sip's maybe try the juce ones.

    They want me to have two a day, but i said that they tended to make me feel full and wasn't eating as much because of it, so i just have the one in the morning.

    My dietician also sent me through some free samples of jelly that do the same thing as the sip's/juce but i wasn't keen on them either !! But that's not to say you may not, so maybe ask about them.