Caregiver stressed to the max

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My husband was diagnosed with nasopharygeal cancer in February. Been through 6 weeks of radiation and 3 doses of cisplatin 3 weeks apart.  He became depressed in March but didn't get help.  Kept telling doctor he was okay. Made it through all treatments without peg and only 16 lb weight loss.  Very last day of radiation found he was in acute renal failure. Spent 16 days in hospital with touch and go, refused to eat, lost 16 lbs , finally treated for depression and peg tube inserted. Discharged with peg feeds 5 times a day. Not a water drinker so lucky if gets 750cc per day. We are now into 14 weeks post radiation.  On antidepressant med. Have had counselor work with him for eating but doesn't follow advice to eat small amounts every 2-3 hours.  Maintaining weight and gaining by Boost Plus shakes with protein and ice cream added. Fearful of nausea and vomiting so if he even tries soft food he immeadiately becomes nauseated, grabs for the bucket and wants to vomit.  Found foods he tolerates and then next time trying doesn't.  Down to one can peg feed per day.  Want to get peg out.  I don't go out much or for very long as I can't count on him to get anything to eat on his own.  I believe he is avoiding eating by watching TV all day and then napping frequently on couch. Says he doesn't think to get anything. I have been waiting on him hand and foot and tired out. I have tried to be strong and supportive but feel I am hitting my limit. 

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  • CivilMatt
    CivilMatt Member Posts: 4,722 Member
    edited July 2016 #2
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    welcome

    Tryinghard,

    Welcome to the H&N forum, where most of us had a special caregiver, like you.

    It is often said that the caregiver’s role can be worse than the patient with little reward.  You need to figure out how to satisfy your nerves while administering to your husband.  Can you find  relief with friends and family?  At a minimum, maybe a visit to your house (after all he is napping).

    Your husband’s doctor should be brought up-to-speed on his mental health.  Maybe, an adjustment to his meds  is called for.

    Bottom line, you can’t do it alone, he needs to get in the game.  He went through  the hardest parts and should be getting better.   All I know is it takes real effort on your husband’s part.  He should want to help out.

    I lost about 48lbs and did not get back to truly normal eating for 7 months.  It is hard, it does take time, but try to set some small goal and be happy when it is achieved.

    Matt

  • The arn man
    The arn man Member Posts: 9
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    Deja Vu

    Your story sounds really familiar. My wonderful wife said those words many times I'm sure. The stage your husband is in is what I call the "any calorie is a good calorie " stage. Nobody told me that the radiation really just started working on you when the treatments were finished. For your husband swallowing is extremely challenging and nothing tastes good enough to be worth the effort. If hes got the tube in use it. Alot. He needs that nutrition and your gonna have to pour it down him. I hated that damn feeding tube. I hated the power port for the chemo too. I couldnt wait to get them out. They made me feel like I had spare parts from "Radio Shack" installed because they couldnt find the real parts. The truth of the matter is he needs the peg until he starts eating on his own. Don't "ween him off" by trying to cut his intake down. I can also tell you that a real ice cream milkshake was my best friend when was trying to at least slow down the weight loss.

    By the way. I tried them all.

    Dairy Queen makes the best fast food milkshake.

    Its not really even close.

  • the_wife
    the_wife Member Posts: 184
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    Hello

    I'm so sorry you and your husband are going through this. I was a caregiver for my hubby who went through a similar treatment. He had a tough time - not as bad as what your husband is going through - but at one point it seemed like he was headed there. Right from the very first chemo, he was very sick and had difficulty holding any food down. He didn't want the tube at first, but thankfully got on board after he was hospitalized for the 2nd time halfway through. We kept up the feedings for several weeks after treatment. It was really tough on me. What Matt says is true. As a caregiver  I ran myself ragged. At one point I almost fainted with exhaustion. We were staying at a Hope Lodge so I had to keep running up and down 2 floors and halfway across the building from our room to the kitchen to try different foods, get water, and meds  throughout the day every day, all day long. As a caregiver you don't get the weekends off. You don't get a break. The only time I got a break was when he was in the hospital. My advice is to take breaks. Go for a walk or meet with a friend. Whatever you do, don't neglect your self-care.

    Also keep in mind you can only do so much - he has to be willing to do the work to get well and not give up. You can't force someone to get well and sometimes food can become a battleground. Let him know about this thread and how well others here have done. I only half-believed things would get better when I was given advice from others who'd been there. But just know this - he will get better ONLY if he is willing. And I'm sure you realize you have to take care of yourself, otherwise your health will suffer. Can a friend or family member come in and help out? Can someone just sit and talk with him and gently encourage him to eat? For me, it's really hard to ask for help, but someone on this thread suggested that I tell his doctors about my concerns with his not eating and as a result they talked to him. Personally I don't think the doctors do enough in this area, so you have to really press the issue with them and then hope that your hubby listens. I think depression plays a big part in this, so hopefully he will continue to be monitored for that. His care providers can and MUST be a partner in his recovery.

    Take care of yourself!

  • caretothepeople
    caretothepeople Member Posts: 18
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    This must be so difficult and

    This must be so difficult and I'm sorry you're going through all of this. Your husband is very lucky to have you by his side during this time, despite how challenges things are. As the previous poster mentioned, your wellbeing is important too and many caregivers benefit from finding support - whether that's from seeking counseling or finding a support group. The American Cancer Society has resources for cancer support groups and there may be some local groups in your area.

  • swopoe
    swopoe Member Posts: 492
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    I am another caregiver here.

    I am another caregiver here. I can sympathize with you, and I am sorry. My husband was very sympathetic towards me and making sure I was ok. In your case, you have to make sure you are ok. You can't take care of your husband unless yountake care of yourself first. Talk to someone- your doctor, us here, a friend, your husband's doctor. Someone. See if someone can come be with your husband for a bit so you can get a break. You need to do this, for you and for him. And your husband needs to get his head in the game too if he wants to get better. Talk to his doctor about this. I am so sorry you guys are going through this. We are here anytime to talk.

  • Barbaraek
    Barbaraek Member Posts: 626
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    Trying Hard

    Your story sounds very familiar to me. My husband was also diagnosed with nasopharyngeal cancer and had a similar treatment plan. One of his doctors called him a "complication magnet". He had his PEG at week 2 and just had it removed 8 months after treatment was done. Lots of problems with swallowing , fear to eat, choking etc. But I will tell you that it does get better! I can't write you the long response I would like to - because 1 year after diagnosis we are on the cruise that we had to postpone because of the cancer being discovered. I'll send you a long message when I get home and have internet I don't have tp pay through the nose for. As far as caregiving goes....don't lose hope, it WILL get better, call in reinforcements and let your team know - they may be able to access some resources for you.

    Barbara

  • Tryinghard
    Tryinghard Member Posts: 18
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    Barbaraek said:

    Trying Hard

    Your story sounds very familiar to me. My husband was also diagnosed with nasopharyngeal cancer and had a similar treatment plan. One of his doctors called him a "complication magnet". He had his PEG at week 2 and just had it removed 8 months after treatment was done. Lots of problems with swallowing , fear to eat, choking etc. But I will tell you that it does get better! I can't write you the long response I would like to - because 1 year after diagnosis we are on the cruise that we had to postpone because of the cancer being discovered. I'll send you a long message when I get home and have internet I don't have tp pay through the nose for. As far as caregiving goes....don't lose hope, it WILL get better, call in reinforcements and let your team know - they may be able to access some resources for you.

    Barbara

    Hope to hear from you

    Oh I hope I will hear from you. The doctors call my husband's journey "a traumatic experience".  We too had to cancel a Panama Canal cruise with another couple this year but hoping to plan to cruise Mississippi next year. 

  • Tryinghard
    Tryinghard Member Posts: 18
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    Deja Vu

    Your story sounds really familiar. My wonderful wife said those words many times I'm sure. The stage your husband is in is what I call the "any calorie is a good calorie " stage. Nobody told me that the radiation really just started working on you when the treatments were finished. For your husband swallowing is extremely challenging and nothing tastes good enough to be worth the effort. If hes got the tube in use it. Alot. He needs that nutrition and your gonna have to pour it down him. I hated that damn feeding tube. I hated the power port for the chemo too. I couldnt wait to get them out. They made me feel like I had spare parts from "Radio Shack" installed because they couldnt find the real parts. The truth of the matter is he needs the peg until he starts eating on his own. Don't "ween him off" by trying to cut his intake down. I can also tell you that a real ice cream milkshake was my best friend when was trying to at least slow down the weight loss.

    By the way. I tried them all.

    Dairy Queen makes the best fast food milkshake.

    Its not really even close.

    feedings

    Well I won't be weaning for the peg to be removed. Just as I thought we were gaining after finding PET scan clean,  the onocology doctor decided my husband's labs look good and he had improved so wants to give three preventive doses of less toxic cisplatin and 5FU starting Monday and give every 4 weeks.  He said they have held off longer then they wanted to.  I am going to need that peg for feed for probablt another 3-4 months with the side effects of more chemo coming.  

     

  • Tryinghard
    Tryinghard Member Posts: 18
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    Thank you

    Thank you. I don't feel so alone after reading your replies. The doctors, nutritionist and counselor talk to him but he comes back home and doesn't seem to listen. He says he is okay but I know different being with him 24/7. Physically yes. Mentally no. Have just been notified all tumor gone-PET scan clean.  ENT said throat looks good. Only now onocolgy wants to give 3 chemo does every 4 weeks for prevention.  Now needs mediport put in. He is ridden with anxiety. Peg feeds will be needed if side efects from chemo are prolonged. Fearful of nausea and vomiting thus limits intake.  I have another 3 months I need to keep myself strong. 

  • susanc1
    susanc1 Member Posts: 24
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    I hope this helps

    My hubby is just getting started with his journey into cancer tx. I am not an expert yet on being a caregiver in this capacity, so I cannot speak from that difficult point of view. However, I am a mental health therapist and maybe I can give you some tips...for you. I agree with what is posted here and that you must take care of yourself. Caregivers tend to be "other-directed" and end up not focusing on themselves, and this affects their well being. If you really can't get out of the house, it is important to focus "here and now." WHen we have a foot in the past (depression) and one in the future (anxiety) we are not in the present. If you have not heard of mindfulness, a quick scan on the internet can get you in the right direction. THe short story here is that practicing being in the moment actually helps overactive frontal lobes take a break, so try coloring (Which I do while waiting in dr. offices), needlework, jigsaw puzzles, cross word puzzles, crochet, anything that lets your mind rest. If I may...gently suggest.....you may need to find a mental health person to talk to. You get a whole hour for someone to simply listen to YOU. There are two online things you might check out. One is called Breakthrough and provides online video counseling and the other is called Talkspace, which allows you to write and have a clincian respond to you in writing, with video options, but allows you a lot of anonymity. And this may sound harsh...and really I don't want it to, so please know that I am coming at this writing from a place of concern......your husband must take responsibility for his recovery.You can help, support, and love him, but he has to decide to get well. Our spouses didn't ask for this disease, it's true. And I never thought I would have to provide care for my husband, (who is, as I write this at the dentist having teeth pulled so he can begin radiation, with a visit to the chemo doc to get that tx plan inplace later today), but I am about to begin my journey doing so. IF you have not expressed your real feelings to him it might help him to know that you are tired, that you need him, tha you want to continue being there for him and that you want him to fight...like you are.
    One of the things I really believe is "meaning precedes motivation." What that means is that until something MEANS something to or for us, we are not particularly motivated to do much about it. Your husband's recovery has to mean something to him, which is why a mental health counselor can help him. He might be interested in the two sites I mentioned earlier. I hope this helps you. It helps me to write it as a reminder that I, too, will need to practice my own preaching. Talking helps, and writing has been found to be even more helpful. I will be glad to offer what support I can :)

    s

  • Livelovelaughalot
    Livelovelaughalot Member Posts: 1
    edited July 2016 #12
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    Take one day at a time and remember Anne's song, Tomorrow

    I am a caregiver for many years to a disabled spouse. My spouse was hit by a car when he was 18 leaving him in chronic leg and back pain,at age 50 he had complications from brain anyserum clipping leaving him with something like dementia and at 63 he had stage 4B throat cancer leaving him in and out of the Hostipal for infections, dehydration, aspiration pneumonia, feeding tube woes and other reasons.  I would advise you to take a day at a time.  You will have good,bad and just horrible days. Just remember Annie's song, " the sun will come out tomorrow,etc".  You have to find the time to take care of yourself, find little things that will bring a smile to your face. I listen to music, pray,garden, cook, trying to write a novel, talk on the phone to friends,family, joined Facebook  giving updates about my family and send messages,etc., take walks with my dogs or myself and go on the Internet to play games,read,etc.  We are both on depression pills and I also take a sleeping pill.  Lately most days are bad for us because my spouse had a wisdom tooth extraction and every day in more pain. Trusted the oral surgeon that everything would be good. Waiting for consultation regarding hbo treatments and back to the Doctor tomorrow. Unable to eat only applesauce with his pills. His radiation and chemo treatments ended 7 months ago. I thought the treatments were the worse part but now realize it's worse after the treatments end. Side effects! So many side effects it will make your head spin. I worry about kidney failure,liver failure and going deaf. Never thought or realized that dental would be a major problem.  So be prepared for the unexpected. Trust in God if you believe as I do.  I wish you and your husband good luck and you will be in my prayers.  Also try different nausea pills. I also am stuck at home,doing 6 cans a day in his feeding tube,crushing pills, etc. His cancer is gone,yeah and we are alive. 

  • wmc
    wmc Member Posts: 1,804
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    Welcome to H&N group

    Welcome and also sorry you need to be here. So far you have had some great advice. Matt hit everything and then what the caregivers added was also great information. Sometimes there comes a point where you just have to tell him that his recovery is up to him. I will be a little blunt and sorry but this is affecting you. 

    Most of the time this cancer can and is harder on the caregiver, You feel all his pain, even when he doesn't have any. It's called love. The treatment for head & Neck cancers is said to be the 2nd worse one can go through. Radiation and chemo does so much and even different in ways to everyone. Many have it so bad they think they just can't do it, but they can and do. It is a road to hell and back in many ways, and is life changing for everyone involved. You need to let him know what you feel and he has to do the same. He needs to know you need to set some time every day aside just for you. If you get run down, and you are, you will be no good for him or yourself.

    I did not experience chemo or radiation. It was explained to me in great detail then he saw the x-rays of my lungs and things changed real quick. My surgeon that I chose and was the head doctor over all of them, came in and sat down and said, you will not survive radiation or surgery because of your COPD.  After a moment he said there is one way we will do this. [The anesthesiologist would not touch me and said he could not keep me breathing.] We will remove your larynx and you will breathe out your neck the rest of your life.  I did say it was life changing. Well, it was not a hard decision to really make, I am really fond of breathing so we'll do the surgery. People will say, I can imagine what that is like. No, they can't, not even come close. Now I can talk as I have a prosthesis in my neck, but it can be hard and if both hands are dirty or full, I can't talk. I have to block the air in my neck and it then diverts to my throat so I have a voice. Now it has been 30+ months and my family knows this but treats me the same as before which is good. Until my hands are full and they ask a question when I am trying to fix something and can't answer. That is when it feels like I just got slapped and made aware I am not the same as before. Now they don't mean to do that and they know I can't answer and they will wait for me. Most days I'm ok with this, but there is some that really get to me.  I think your husband just may feel the same sometimes. He knows he has changed and then add the kidneys? It can be a lot. If he could maybe talk with others it might help, but it could be hard to get him to go. I volunteer with two support groups and I have been able to help many, and even myself.  I will keep you both in my thoughts and prayers. He may be in denial and just won't really accept it. Once you accept this is when you can heal.

    Bill.

  • DarcyS
    DarcyS Member Posts: 81 Member
    edited July 2016 #14
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    Also a caregiver

    I, also, was my husband's caretaker through his long and difficult treatment( stage lV piriform sinus cancer  T1N2M0) We are now 4 years clear and life is good.  Eating was difficult for my husband after about week 3 of radiation due to taste, pain and vomiting.  He would have 4 ensures a day and no solid food at all.  He knew how many he needed in a day and I would ask him througout the day when he planned the next one.  The questions seemed to help and put him in charge of it and I would remind him of the time if it passed. It was hard due to the coughing and vomiting but he knew these were like medicine and needed for recovery.  He did not have a peg and didn't want one.   He began eating some solid food about 6 weeks after treatment and everything just continued to get better.  

    Visit this site often, it can be a lifeline and place filled with understanding, knowledge, and helpful people.

  • susanc1
    susanc1 Member Posts: 24
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    DarcyS said:

    Also a caregiver

    I, also, was my husband's caretaker through his long and difficult treatment( stage lV piriform sinus cancer  T1N2M0) We are now 4 years clear and life is good.  Eating was difficult for my husband after about week 3 of radiation due to taste, pain and vomiting.  He would have 4 ensures a day and no solid food at all.  He knew how many he needed in a day and I would ask him througout the day when he planned the next one.  The questions seemed to help and put him in charge of it and I would remind him of the time if it passed. It was hard due to the coughing and vomiting but he knew these were like medicine and needed for recovery.  He did not have a peg and didn't want one.   He began eating some solid food about 6 weeks after treatment and everything just continued to get better.  

    Visit this site often, it can be a lifeline and place filled with understanding, knowledge, and helpful people.

    Inspired

    My hubby doesn't want the PEG either and I want to support him with his choices. I like that yours knew how many he had to drink daily and I we will suggest the idea of setting times for my husband when/if we get to that spot. His doctor told hi that while the ensures ad all the nutritional values needed for the day, it wasn't enough caloric intake for him, so I was wondering if your husband supplemented these drinks with anything else?

     

    s

  • Tryinghard
    Tryinghard Member Posts: 18
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    Need help with nausea vomiting issue

    Did anyone still have nausea or vomiting way ater treatments- like months?   Both radiation and chemo were finished in April.  Vomiting occurs at least once a week out of the blue. Sometimes it seems like it is anxiety related- like after anticpation about an appointment, other times it is like an after effect from a busy joyful day, and then maybe could be if he had too much shakes and peg feed. l can't figure out if this is a usual expected side effect or whether he has a stomach issue that needs to be evaluated.  He is about to start preventive doses of cisplatin and 5FU to make sure nothing microscopic is still around so I expect nausea and vomiting will be from that but right now he is way past treatments.

     

  • DarcyS
    DarcyS Member Posts: 81 Member
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    susanc1 said:

    Inspired

    My hubby doesn't want the PEG either and I want to support him with his choices. I like that yours knew how many he had to drink daily and I we will suggest the idea of setting times for my husband when/if we get to that spot. His doctor told hi that while the ensures ad all the nutritional values needed for the day, it wasn't enough caloric intake for him, so I was wondering if your husband supplemented these drinks with anything else?

     

    s

    Calorie intake

    He was told 3 ensures were not enough but 4 were.  This was a bit of a battle, but his PA was adamant  and he listened to her. He added a product called, Juven, into water for added protein once a day as well, though this didn't add many calories.  He began to slowly add solid food back into his diet about 6 weeks after treatment and is totally back to eating anything and everything he wants.  

  • DarcyS
    DarcyS Member Posts: 81 Member
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    Need help with nausea vomiting issue

    Did anyone still have nausea or vomiting way ater treatments- like months?   Both radiation and chemo were finished in April.  Vomiting occurs at least once a week out of the blue. Sometimes it seems like it is anxiety related- like after anticpation about an appointment, other times it is like an after effect from a busy joyful day, and then maybe could be if he had too much shakes and peg feed. l can't figure out if this is a usual expected side effect or whether he has a stomach issue that needs to be evaluated.  He is about to start preventive doses of cisplatin and 5FU to make sure nothing microscopic is still around so I expect nausea and vomiting will be from that but right now he is way past treatments.

     

    Vomiting

    My husband starting vomiting after the 3rd week of radiation.  It seemed to be triggered by coughing and his gag reflex was very sensitive.  He also had some nausea as well.  The vomiting was daily and continued for about 5  or 6 weeks post treatment.