Phlegm management

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If the updside down picture didn't tip you off already, I'm new to the site. I'm HPV+ SCCHN IVA, t1,n2,m0 and started concurrent chemo (cis-platin) and radiation (IMRT, twice daily) on 1/3/12, so I'm a day short of 3 weeks of treament in a 6 week regimine, and crossing off the days one at a time! I've gotten meds to the thursh and to help with the pain in my mouth and pain of swallowing, but I'm really struggling with phlegm. Since I can't 'pull it up' into my mouth due to pain, It accumulates down at the epiglotis, I suppose, and waits for me to swallow it down. This is accomplished by a great deal of snorting and hawking back and forth as I try to be sure it's loose and ready to go before I cash in a swallow (because, of course, every swallow is precious and oh, so painful!). This is becoming an all consuming task day and night. Do you have some suggestions? Is there any way to aspirate it? Any tricks to reduce it? I'm open to any ideas you may have and thank you in advance for your help! -- Tagboy

Comments

  • Skiffin16
    Skiffin16 Member Posts: 8,305 Member
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    Welcome
    I didn't really suffer with the thick phleghm too much I think mainly because I had Amifostine Injections each day just before the rads...

    I know several others have though and will chime in soon...

    Here's a link to the SuperThread of contributions, links, etc....

    SUPERTHREAD

    Again, welcome to the forum, you'll find the people pretty great and knowledge and experience invaluable.

    Best,
    John
  • Tagboy
    Tagboy Member Posts: 6
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    Skiffin16 said:

    Welcome
    I didn't really suffer with the thick phleghm too much I think mainly because I had Amifostine Injections each day just before the rads...

    I know several others have though and will chime in soon...

    Here's a link to the SuperThread of contributions, links, etc....

    SUPERTHREAD

    Again, welcome to the forum, you'll find the people pretty great and knowledge and experience invaluable.

    Best,
    John

    Thanks!
    Thanks, Skinfin. Nice fish! I've been stalking the forum quietly for a week and logged in this week for the first time... Taking things one day at a time but with all the surprises, I know I'll need folks I can reach out to. For me really only the mouth issues have been an issue. No one mentioned to me the injections... I'd have tried them for sure. So far really just getting ahead of the mouth pain with meds and getting to where I don't spend half my time trying to successfully swallow globs of stuff has been the challenge. Where was your pic taken, if you don't mind me asking?
  • QT314
    QT314 Member Posts: 5
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    Plegm management
    Hi - I too had serious phlegm issues. I can honestly say it was probably the most unpleasant side effect of the whole cancer treatment. The good news though, is it was short-lived (just a few weeks) and got better very quickly once treatments stopped. I have no problems swallowing at all now and even taste is coming back quickly now (I am 6 mos. past treatment). Looking back it seems like ancient history. I even used a machine which helped get rid of the phlegm and it did help me quite a bit (it was insane how many boxes of tissues I was going through!). All I can say, is do what you can to make yourself comfortable and just push through those weeks and you'll be doing great soon.
    Just be sure to keep swallowing every day. It really is important. Also, in my case, it was important to keep doing stretching exercises of the neck to keep everything from stiffening up (scar tissue forms while you are healing and you want to keep everything as limber as possible).
    Good luck to you and keep on keeping on.
  • robinleigh
    robinleigh Member Posts: 297
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    My husband, Andy, had that horrendous problem around the same time as you. A suction machine was talked about but, we never took advantage because he felt like the phlegm was too far down for the device to reach and do any good. He ended up taking pretty high doses of Mucinex (guaifenisin I believe is the generic name) because we could buy it in a liquid form since pills at that point were impossible to swallow. You may want to ask your docs about a dosage if they think it would be worth a try. It's supposed to thin out the secretions.

    So sorry. Just remember...it is a passing stage. Andy stood over the sink for half of his life during that time. Now, zero phlegm!
  • fisrpotpe
    fisrpotpe Member Posts: 1,349 Member
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    i hated
    i hated those days, weeks and probably a total of 1 1/2 months. about the same time your at in treatment i was at the same place, all my energy was spent hacking the crap up to spit out very little. the biggest help was for me was a suction machine that my sisters went on hunt for, mind you that was 16 years ago. anyway they are portable, used by many. talk to your doctors and nursers they can order you one up. it is used by many with trachs. they have a wand on the end and pulls it out of you mouth and way in the back of you mouth where the throat begins. the moment i used for the first time i cried as it was so easy.

    other than iv fluids i believe it to be the most valuable tool you can use to help in the fight min. by min.

    welcome, you have come to the right place for support and information.

    john
  • Skiffin16
    Skiffin16 Member Posts: 8,305 Member
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    Tagboy said:

    Thanks!
    Thanks, Skinfin. Nice fish! I've been stalking the forum quietly for a week and logged in this week for the first time... Taking things one day at a time but with all the surprises, I know I'll need folks I can reach out to. For me really only the mouth issues have been an issue. No one mentioned to me the injections... I'd have tried them for sure. So far really just getting ahead of the mouth pain with meds and getting to where I don't spend half my time trying to successfully swallow globs of stuff has been the challenge. Where was your pic taken, if you don't mind me asking?

    Skyway Bridge - Tampa Bay...
    It was sitting on the bow of my boat under the Skyway Bridge Tampa Bay Florida a few months ago.

    I live in Lakeland, between Orlando an Tampa, so I primarily fish Tampa Bay....

    Check out my expressions pages, several photos of fishing catches...LOL. I get out most every week-end usually (if I get my honey doos and yard work done first, which I try to do during the week)...

    I'm definitely a lucky man...a beautiful wife, two good kids, two lovable and goofy chocolate lab sisters, great job, nice boat, and awesome friends...life is good.

    Best,
    John
  • Tagboy
    Tagboy Member Posts: 6
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    fisrpotpe said:

    i hated
    i hated those days, weeks and probably a total of 1 1/2 months. about the same time your at in treatment i was at the same place, all my energy was spent hacking the crap up to spit out very little. the biggest help was for me was a suction machine that my sisters went on hunt for, mind you that was 16 years ago. anyway they are portable, used by many. talk to your doctors and nursers they can order you one up. it is used by many with trachs. they have a wand on the end and pulls it out of you mouth and way in the back of you mouth where the throat begins. the moment i used for the first time i cried as it was so easy.

    other than iv fluids i believe it to be the most valuable tool you can use to help in the fight min. by min.

    welcome, you have come to the right place for support and information.

    john

    Thanks!
    Thanks to all three of you for your commiseration and suggestions. I'm thrilled to know it doesn't last too long past treatment and I should get an IV tomorrow if we can't find a home health today. I know I'm dehydrated and just can't swallow liquids. I do 'dry swallows' just to keep the machinery running (and stay familiar with that nice rubbing burn). Thinking back, My Doctor should have re-directed my statement "One of my goals is to not have PEG." and suggested I get one anyway before treatment started and then just have the goal of "...not use the PEG." Becuase I'm down to some 2,000 calories in the last three days and none yet today... due to pain of consumption of the ensure. Will meet with Dr. in the AM and get scheduled for the PEG right away. Thansk again... I'm sure you'll be seeing me flailing about again soon!
  • Skiffin16
    Skiffin16 Member Posts: 8,305 Member
    Options
    Tagboy said:

    Thanks!
    Thanks to all three of you for your commiseration and suggestions. I'm thrilled to know it doesn't last too long past treatment and I should get an IV tomorrow if we can't find a home health today. I know I'm dehydrated and just can't swallow liquids. I do 'dry swallows' just to keep the machinery running (and stay familiar with that nice rubbing burn). Thinking back, My Doctor should have re-directed my statement "One of my goals is to not have PEG." and suggested I get one anyway before treatment started and then just have the goal of "...not use the PEG." Becuase I'm down to some 2,000 calories in the last three days and none yet today... due to pain of consumption of the ensure. Will meet with Dr. in the AM and get scheduled for the PEG right away. Thansk again... I'm sure you'll be seeing me flailing about again soon!

    PEG
    Though I didn't have the PEG, I highly endorce them if needed.

    That being said, I can understand where you are coming from concerning swallowing and pain management.

    I too survived for around 6 - 7 weeks solely on Ensure Plus, a few sliced peaches (DelMonty in jars), and water. Ofcourse preceded with pain meds and followed with more pain meds.

    You should definitely communicate with your MD's if you can't swallow due to pain and they can prescribe you something.

    For me I had a routine....

    I would set up two glasses of water, 1- 2 Ensures, a few of the peaches....a ground up percocet in just a little water, the thick throat/mouth numbing solution or liquid hydrocodon...I even had liquid morphine (roxanal), but didn't like it and it did nothing for my pain...it made me nauseaous.

    Anyways, I'd take a teaspoon of the liquid meds, drink a galss of water, the Ensures and slide the peaches down to help with swallowing muscles...more water, then the percocet....

    I'd follow that routin a few times a day to keep the calories and hydration going..

    Anyways, don't suffer the pain if you can get something for it.

    Best,
    John
  • hawk711
    hawk711 Member Posts: 566
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    Skiffin16 said:

    PEG
    Though I didn't have the PEG, I highly endorce them if needed.

    That being said, I can understand where you are coming from concerning swallowing and pain management.

    I too survived for around 6 - 7 weeks solely on Ensure Plus, a few sliced peaches (DelMonty in jars), and water. Ofcourse preceded with pain meds and followed with more pain meds.

    You should definitely communicate with your MD's if you can't swallow due to pain and they can prescribe you something.

    For me I had a routine....

    I would set up two glasses of water, 1- 2 Ensures, a few of the peaches....a ground up percocet in just a little water, the thick throat/mouth numbing solution or liquid hydrocodon...I even had liquid morphine (roxanal), but didn't like it and it did nothing for my pain...it made me nauseaous.

    Anyways, I'd take a teaspoon of the liquid meds, drink a galss of water, the Ensures and slide the peaches down to help with swallowing muscles...more water, then the percocet....

    I'd follow that routin a few times a day to keep the calories and hydration going..

    Anyways, don't suffer the pain if you can get something for it.

    Best,
    John

    Hey Tag
    I remember the thick mucous well. Mine lasted for 4 weeks after treatment, then the dry mouth kicked in. From one extreme to another.
    I used a suction machine and it was a god send. Try it before you say it won't work for you. It cleared me up enough to sleep, which I needed.
    I understand the issue of PEG and hydration. I had and used a PEG for 11 months and got IV's of hydration for 2 months during treatment. The PEG will give you nutrition and keep your weight up as well as give you water if you can't swallow.
    I practiced swallowing with thicker stuff, yogurt, pudding, and soups. This is actually easier to swallow than water because water is so thin.....
    I wish you the best in getting through this crap.....It does end, I can promise you that, but it will take way longer than you'd like. so be patient, very patient. Think in terms of weeks and months to get better, not days. In 6+ months, you'll see a different world and it will be a good one....Keep up the positive attitude......all the best.
    Steve
  • pitbull4me
    pitbull4me Member Posts: 4
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    hawk711 said:

    Hey Tag
    I remember the thick mucous well. Mine lasted for 4 weeks after treatment, then the dry mouth kicked in. From one extreme to another.
    I used a suction machine and it was a god send. Try it before you say it won't work for you. It cleared me up enough to sleep, which I needed.
    I understand the issue of PEG and hydration. I had and used a PEG for 11 months and got IV's of hydration for 2 months during treatment. The PEG will give you nutrition and keep your weight up as well as give you water if you can't swallow.
    I practiced swallowing with thicker stuff, yogurt, pudding, and soups. This is actually easier to swallow than water because water is so thin.....
    I wish you the best in getting through this crap.....It does end, I can promise you that, but it will take way longer than you'd like. so be patient, very patient. Think in terms of weeks and months to get better, not days. In 6+ months, you'll see a different world and it will be a good one....Keep up the positive attitude......all the best.
    Steve

    I also had tremendous
    I also had tremendous phlegm, the suction machine was awesome! I used it for 1 1/2 months. I was vomiting from the phlegm. My throat burns were so severe from radiation that I could only handle ice chips and had to let them melt in my mouth. I was unable to drink water or anything else as it came to fast and I could not swallow. Still, a yr. later I sometimes have swallowing issues. All of my meds were given via port a cath, due to swallowing issues. Unfortunately, before the swallowing got bad, my taste buds were gone and I would vomit up anything and everything that went in my mouth, except ice chips.

    Good luck! And, like others have said, it does get better! Take it day by day, thats what I had to do.