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Mucositis, throat cancer, fever

vocalcord54
Posts: 7
Joined: Apr 2013

Stage 1 vocal cord cancer, being treated with radiation only, 28 treatments.  22 treatments in, my husband spiked a fever of 101, coinciding with very think mucus in his throat which causes him to cough and hack, especially after laying down. They checked him out at the ER twice, and found no infection or known virus.  The fever stayed high for 4 days, but has now settled to staying below 99 most of the time.  Treatment was stopped after the 24th, giving him 6 days off to try to get the inflamation down. 4 more treatments starting Monday, hopefully! The throat pain is pretty severe, and he is not able to swallow pills  or anything but small bites of soft food, because everything gets caught in his throat.  He frequently gags on the mucus. His voice is just a painful whisper.

He is using liquid morphine for pain, tylenol and naproxen for pain and fever, lidocaine/benedryl/maalox magic rinse and swallow, and also salt and soda water rinse.  Also uses an extra half dose of benedryl at bedtime.

Fortunately, he doesn't have any soreness or other side effects in his mouth, just his throat.

Questions:

1. Anyone experience unexplain fever during radiation treatment, or have an explanation that our docs haven't found? All we have got is "some virus" and "radiation fever" (to which the oncologist says there is no such thing).

2. Is there anything else we can do to help him with the mucus and pain?

3. How long after treatment can we expect these side effects to last?

I feel so bad for him and it is so frustrating not being able to help!  

Thanks for any help anyone can offer!  Our prayers go out to all of you! 

 

  

 

 

KTeacher
Posts: 938
Joined: Jan 2011

So sorry for his side effects of rads.  Please check the Superthread, loads of information and helpful hints to get through treatment.  I didn't have the mucus as bad as others, many shared that they kept a cup nearby and plenty of Kleenex.  I couldn't lay flat to sleep, that was when the gagging would start.  Extra pillows (I am known as the pillow queen at the hospital) or recliner chair, I spent many nights on the recliner with my blankie.  Good luck to you, you are almost near the end.This sounds weird but a little bit of Root Beer or Sierra Mist helped break up the mucus for me.

KTeacher
Posts: 938
Joined: Jan 2011

Not to frustrate you but side effects do continue for weeks after treatment.  You don't go to treatment daily and wonder how you did it.  Continue with fatigue and pain.  I finished treatment at the end of February and it wasn't until mid April that I was starting to feel better.  Not back to 'normal' yet but less fatigue and more eating.

vocalcord54
Posts: 7
Joined: Apr 2013

Thanks, KT!  Several people have talked about sleeping in a recliner, with a wedge, or piles of pillows, and I think that should help (he actually stole my pillow today!).  Never heard of the soda thing, so will try that. 

jcortney's picture
jcortney
Posts: 423
Joined: Sep 2012

I could not sleep laying down and, even now almost three months out of treatment, still don't.  Helps a whole lot with the mucous.  I also found Musinex D gave me some relief.

Joe

Mrs. Sarge
Posts: 198
Joined: Apr 2012

Sounds pretty much like my journey!  Don't want to depress you but for 2-3 weeks after rads are over, he's not going to feel any better, then the healing starts!  My DX was similar, Stage 1, vocal cord, I also had 28 days, mine were about 1 min. long. Both sides of my vocal cords were radiated.  I got very red, angry looking throat, but never blistered or peeled as I faithfully put on the cream they gave me.  That goes away quickly after rads stop.  I too had the coughing/mucous/choking....not fun!!  The fever I didn't have so his Dr is probably right, that it's a virus or something.  I couldn't speak very well before the rads or during but since my voice has gotten better and can talk on the telephone and order from a drive-thru!  Still can't sing but that's fine, glad to have a voice!  He'll survive, just take it day by day, just get through it!  These boards will give you lots of encouragement and tips.  Someone has been through about everything!  We'll be thinking of you both on this journey!

hwt's picture
hwt
Posts: 1935
Joined: Jun 2012

If the soda above is difficult to get down, you might try room temperature. Also, if speaking is difficult try a small dry erase board. My sister-in-law, a nurse, got me one at the dollar store and it was a huge help. 

vocalcord54
Posts: 7
Joined: Apr 2013

Thank you!  It's encouraging to hear from people who have been through the same things.  He is so pitiful but we know how many have been through far worse!  Only 4 more treatments to go and then hopefully things will start getting better.  

CivilMatt's picture
CivilMatt
Posts: 2964
Joined: May 2012

VC54,

Can’t help with the fever, but everything else sounds like “par for the course”.  I had a sink in the utility room dedicated to gag, spit, dry heave, spit.  I went through a 6 pack of Magic Mouth Wash (loved the stuff).  For me, the items you mentioned peaked soon after treatments ended and slowly got better.

I often thought it must be worse for the caregiver to listen to all the hacking, choking and spitting, but hey then life would be predictable.

Anyway, welcome to the H&N forum, both sorry and glad you could make it.

Matt

Tim6003's picture
Tim6003
Posts: 1495
Joined: Nov 2011

I had an unexplained fever of 102 almost at the end of treatments. It was during a break I had to have due to neck burns got so bad.  Doctors really did not know why the fever (lasted a couple of days only) but to be safe they gave me an antibiotic......never heard anyone call is rad fever but it sure makes sense to me, if no virus or bacterial infection, then what could it be from (but then I'm no doctor).

 

It took me a SOLID month to get out of bed in any decent fashion after my last tx....2.5 months after rad I went back to work.

I thought the mucus would NEVER go away...it lasted for 5 weeks hard after rad then it was as if one day a switch went on and the mucus suddenly got better....

 

Bottom line is no matter how long your husband's last, it will improve.  So hang in there.  Keep us posted ...gald to hear he is just a few tx from being NED :)

 

Tim

vocalcord54
Posts: 7
Joined: Apr 2013

Thanks, Tim.  I am with you on the prayers for sure!  I think I am going to push for him to get a round of anitbiotics.  This is a teaching hospital (WVU) and they don't like to use anitbiotics unless they can prove the need, but for crying out loud how many days of unexplained fever does a person have to have before they take a step that could address this?!  He got up this morning, again, with a fever over 100.  Enough!

vocalcord54
Posts: 7
Joined: Apr 2013

Thanks, Matt.  I like your attitude!

Sam999
Posts: 305
Joined: Mar 2012

make sure he is getting enough fluids, radiation does generate lot of heat in body so it is very important to stay hydrated. If you are in a area where fresh coconut  is available, try that. I found coconut water tasted much better and was very cooling to body. Get the green coconut, not the white thai ones. 

 

i had unexplained fever for two days but it went away on its own. Sometimes genera fatigue also causes fever. My doc said if icreases and keeps increasing than only they suspect infection. 

 

hope he feels better soon

 

sam

vocalcord54
Posts: 7
Joined: Apr 2013

It has now the 10th day since the fever began.  He has been to the ER twice, blood work, blood cultures, urinalysis, chest xray, nothing shows the cause. Treatments were stopped 4/24, but have resumed 4/29 and only 2 more left.  His stomach is now torn up from the naprosyn, started using enteric-coated aspirin, stomach is worse so no more aspirin, ibuprofen or naprosyn, just tylenol. The fever is worse at night, but ranges from normal to over 102 throughout the day. Doing research on my own, found sub-acute thyroiditis as a possibility, doc concurred and ordered the thyroid test, but it is normal. Everyone says this is not normal, but no one has an explanation.  The fever is worse than the throat pain and mucus, although heaving mucus especially in the morning is a close 2nd!  I just wish there was something else I could do for him. 

I suspect once his final treatment is done tomorrow (!!!!) things will start to calm down.  Thanks to all for your support!

 

fishmanpa's picture
fishmanpa
Posts: 1113
Joined: Jan 2013

Hi Vocalchord,

Sorry to hear about the mystery fever. I hope they figure out what's causing it. It's bad enough dealing with the side effects of treatment let alone a fever to boot!

Concerning things calming down after treatment? Most will tell you that the first 2-3 weeks out of treatment are as bad or worse. I'm here to tell you, one week out of treatment, that's true. I finished the 24th of April and I'm not any better...yet. I'm also dealing with an adjustment to tube feeding which I find challenging. I expect that by the weekend I should start to feel some minor progress. 

Now this mucous. I heard a lot about it and it didn't bother me until about 2-3 weeks out. Then? The stuff coming out of me could audition for Ghostbusters IV! I will say that is one area I've actually seen a little improvement. A week out and the mucous is abating slightly. I've taken to sleeping in a recliner or, if in a bed, with lots of pillows. It's not the most comfortable position to sleep but it certainly has helped with the mucous. 

Positive thoughts and prayers

"T"

HobbsDoggy
Posts: 165
Joined: Feb 2013

Seems like a weak suggestion but Mucinex helped me. 

vocalcord54
Posts: 7
Joined: Apr 2013

We ended up in the ER one more time, this time admitted, and after 5 days of IV antibiotics and now 5 days out of the hospital on pill-form antibiotics, his fever has been staying down below 99.  All the blood tests, blood cultures, urinalysis, chest xray, chest CT scan, swallowing test, and espophagus scope never did find the source of the fever.  He had his last radiation treatment 5/7!  He still has some mucus issues and his throat is still very sore, but he is starting to be able to eat more and appears to be on the mend. 

Thanks again to all who offered suggestions to help!  God bless each and every one of you!

 

 

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