Complication after surgery - question about saliva and lifestyle

LK1993

Hi all!  My father had surgery for Esophageal Cancer this summer, please excuse my non-techinical terms but I want to make this as clear as I can so I am understood

 He had a total laryngectomy and the plan was to remove the larynx and the cancer ridden esophagus in the upper throat and replace the esophagus w/ a piece of intestine.  The surgery worked like a charm for the first few days, then the transplant failed and he had to have emergency surgery to save his life.

Unfortunatly, the doctors were only able to save him by totally and permanently closing off what remained of his esophagus and then permanently closing off the back of his throat and creating a hole under his chin for saliva drainage.

The good news is since all this happened in July he is totally healed from the surgery and the doctors are 99.9% sure all the cancer is gone.  He is having a scan right after the 1st of the year to confirm this.  He is doing well w/ his oral EL and getting back his regular routine as much as possible.

The problem is saliva management.  He is constantly battling the saliva that runs out the hole they made under his chin.  The fact that what they had to do for his case is quite uncommon is where we are running into issues.  We are thinking outside the box for a way to collect the saliva so he says more comfortable.  My mother fashioned up a little bib for him which works, but has to be changed every 30 minutes or so.  It's irritating to him and we are hoping to get some ideas for a better system.  The doctors don't think a gastric pull up is in the cards so we are looking at ways to make this more livable.

I am hoping we can find someone else who has had this issue and brainstorm a saliva collection device.

Of course b/c of what has happened, he is on a permanent peg tube.  If we could figure out a device to hook up to a collection bag - I am thinking something like a funnel attached to a bag to attach to the opening in his chin....not only could he have better saliva management, but it might let him eat (for pleasure only) a bit too.  Right now he sips on water, beer and white wine and spits into a glass.  If he could cover the hole somehow - it would open up a wider amount of things he could taste.

Anyone else have a similar issue or know of someone who does?  I am going to go through all the form messages and also cross post this in Head and Neck Cancers but did want to stop here first!

paul61

Perhaps something like this may work?

LK1993,

I am sorry to hear of your Dad’s post-surgery complications; but glad to hear he is healing and hopefully with scans that show no evidence of recurrence.

 I have to admit that for the five plus years that I have been a part of the particular forum I have not heard of another case quite like your Dad’s. You may have better luck in the head and neck cancer forum areas.

One idea that does come to mind; after my esophagectomy with gastric pull up I contracted a hospital infection in my surgical incisions, this necessitated reopening my wounds, and as a result extended healing time. One of the medical devices used to accelerate the healing process was a device called a “wound vacuum”. This device included an air tight dressing that contained a thin tube that ran to a small vacuum unit that could be worn on a belt or with a shoulder halter. The small pump maintained a mild vacuum under the dressing that collected any seepage discharged from the wound into a small reservoir in the pump unit. The dressing and reservoir were changed periodically. The purpose was to keep the wound clear and to accelerate the healing process. I wonder is such a device could also be used to deal with your Dad’s saliva?

If your local medical facility has a “wound clinic” this would be the kind of place you might find someone who is willing to “think outside the box” in helping your Dad be more comfortable.

Wishing for clear scans and a solution for your Dad’s comfort.

 

Best Regards,

Paul Adams

McCormick, South Carolina

 

DX 10/2009 T2N1M0  Stage IIB - Ivor Lewis Surgery  12/3/2009
Post Surgery Chemotherapy 2/2009 – 6/2009 Cisplatin, Epirubicin, 5 FU
 Five Year Survivor

LK1993

paul61 said:

Perhaps something like this may work?

LK1993,

I am sorry to hear of your Dad’s post-surgery complications; but glad to hear he is healing and hopefully with scans that show no evidence of recurrence.

 I have to admit that for the five plus years that I have been a part of the particular forum I have not heard of another case quite like your Dad’s. You may have better luck in the head and neck cancer forum areas.

One idea that does come to mind; after my esophagectomy with gastric pull up I contracted a hospital infection in my surgical incisions, this necessitated reopening my wounds, and as a result extended healing time. One of the medical devices used to accelerate the healing process was a device called a “wound vacuum”. This device included an air tight dressing that contained a thin tube that ran to a small vacuum unit that could be worn on a belt or with a shoulder halter. The small pump maintained a mild vacuum under the dressing that collected any seepage discharged from the wound into a small reservoir in the pump unit. The dressing and reservoir were changed periodically. The purpose was to keep the wound clear and to accelerate the healing process. I wonder is such a device could also be used to deal with your Dad’s saliva?

If your local medical facility has a “wound clinic” this would be the kind of place you might find someone who is willing to “think outside the box” in helping your Dad be more comfortable.

Wishing for clear scans and a solution for your Dad’s comfort.

 

Best Regards,

Paul Adams

McCormick, South Carolina

 

DX 10/2009 T2N1M0  Stage IIB - Ivor Lewis Surgery  12/3/2009
Post Surgery Chemotherapy 2/2009 – 6/2009 Cisplatin, Epirubicin, 5 FU
 Five Year Survivor

Thanks for the idea

I will let my parents know about the wound vacuum as a thought.  

My fathers surgeon has said pretty bluntly that his case is not at all the norm and finding measures to help his comfort and ease with the saliva will be trial and error.  So....we are looking everywhere for ideas.  Your vacuum idea sounds really intriguing.

Thank you so much for the reply!  Happy New Year!

luv2dance

Complication after surgery - question about saliva and lifestyle

I am so sorry to hear of your dad’s dilemma. I can only imagine how inconvenience and annoying… My husband had a feeding- tube placed during his ESOPHAGECTOMY surgery. When the j-tube was removed, the incision hole did not heal. This resulted in secretions and bile running out of the incision at will. We taped gauze to it at first, but like in your dad’s case, was very high maintenance, needing changing within an hour, or he was soaked. Clearly, far from a doable solution. The constant secretion kept his skin uncomfortably tender,   clothes wet, stained, and more.  What helped was the utility of an ostomy bag to collect the secretions. In doing so, it relieved the tender skin, wet clothes and was both easy and painless to change.    The ostomy bag we used had two parts; the “base” covered the incision hole where the secretions drained. The other piece was actually a bag that fit over the base and collected the secretion. The bag was translucent and we could see when the bag needed changing. The base seldom needed changing. The bags are available in different sizes. Hopefully there will be one comfortable enough to fit under his chin, or bib.  There was never any spillage from the bags. No more wet or irritated skin. . A womb center or your doctor will be able to assist you in obtaining trying an ostomy bag as a solution.     Best wishes to you and your dad. Tish