Has anyone had to battle the doc and nurses over hydration???

nancyann3
nancyann3 Member Posts: 173 Member
edited March 2014 in Esophageal Cancer #1
We are getting big resistance when it comes to xtra hydration at home or during chemo. It seems the more we ask the less they want to give.
Steve just started his third round of chemo treatment. Same two drugs, just higher dose and less often. (he only has two sessions with this round) One is cisplatin where he goes in for the infusion and the 5fu is hooked to a fanny pak and runs 96 hours. Then he waits two weeks and does it again. He is now getting rad to along with this for 5 weeks. We now have one liter at infusion of the cisplatin and no home hydration. No hydration while the 5fu is running either. When we asked about it, they tell us they are worried about over hydration and he needs to work on drinking enough and stop depending on iv hydration. I tried to explain that he does drink alot but EC patients cant keep up, if they drink enough to protect the kidneys from the cisplatin, they are to full to eat. Am I wrong when I say this?? His labs don't show dehydration so they wont give any. Dont get me wrong, I am glad we can keep it so his labs dont show, but all we want it a little xtra, once or twice a week. It just seems to help all around.

Just wanted to see if I am totally off base here.
Thanks for any input.
Nancy

Comments

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  • Donna70
    Donna70 Member Posts: 852 Member
    unknown said:

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    hospitalized for this regimen
    Hi,
    When I was getting the cisplatin and 5 FU it was my drs policy to hospitalize patients so they would get enough hydration, at least ones of my age, I was 65 and I still needed to come in at least twice a week between the treatments. I got atrial fib and neutropenic fever so I would say more hydration the better. We had a regular cancer center and your dr would say you needed to go and get an infusion and you would be told to call up if you were having dizziness or major weakness problems. They never acted anyway but positive and seemed to understand you cannot get that much fluid in yourself. Can't understand why anyone would argue over hydration. I also got really bad kidney function even with all the extra hydration and had to be hospitalized over that. It is important. take care,
    Donna70
  • Callaloo
    Callaloo Member Posts: 135
    Have you asked the radiation oncologist?
    I didn't know enough then to ask for extra hydration at the beginning so I don't know what the response would have been, but when I got sicker after the second round of chemo and 4 weeks of radiation, and became unable to get enough water by mouth, the clinic easily offered it even though my lab work was still good. The radiation oncologist whom I saw every week understood fully that the combined effects of chemo and radiation would make it impossible to get sufficient hydration by mouth. She was the one who cautioned me about this and offered the extra IVs as the radiation kicked in, not the chemo team. I was getting radiation at the junction and at the collarbone.
  • nancyann3
    nancyann3 Member Posts: 173 Member
    Callaloo said:

    Have you asked the radiation oncologist?
    I didn't know enough then to ask for extra hydration at the beginning so I don't know what the response would have been, but when I got sicker after the second round of chemo and 4 weeks of radiation, and became unable to get enough water by mouth, the clinic easily offered it even though my lab work was still good. The radiation oncologist whom I saw every week understood fully that the combined effects of chemo and radiation would make it impossible to get sufficient hydration by mouth. She was the one who cautioned me about this and offered the extra IVs as the radiation kicked in, not the chemo team. I was getting radiation at the junction and at the collarbone.

    Thanks so much for your replies
    All your comments are just what I thought too. When I try to explain this I meet with more resistance. They say they have to be able to justify giving fluids. If lab work doesn't show it, no hydration. Unfortuantly when the lab work shows it, its to late, but they dont see it that way. I believe after todays descussion and the other days about hydration, I think I have finally figured out why the big resistance...........MONEY!!!!! and insurance. Giving a little xtra fluids is a luxury.

    Thanks again
    Nancy
  • nancyann3 said:

    Thanks so much for your replies
    All your comments are just what I thought too. When I try to explain this I meet with more resistance. They say they have to be able to justify giving fluids. If lab work doesn't show it, no hydration. Unfortuantly when the lab work shows it, its to late, but they dont see it that way. I believe after todays descussion and the other days about hydration, I think I have finally figured out why the big resistance...........MONEY!!!!! and insurance. Giving a little xtra fluids is a luxury.

    Thanks again
    Nancy

    This comment has been removed by the Moderator