Serious Cough, Seriously Malnourished

Jenny32
Jenny32 Member Posts: 23
edited November 2011 in Esophageal Cancer #1
The last couple of weeks have been rough with my dad to say the least. Treatments are starting to catch up to him and I had to have him transported to the ER last weekend because he was so fatigued. He now weighs under 100 lbs. His blood work was fine and so they gave him 2 bags of fluids and they discharged him. The last time he was there, the week prior, he had fluid removed from around his lung and so they checked for a pleural effusion again but I guess it didn't sound severe enough to remove any fluids again. He seemed a little better the following day or so but we are back to square one again. His cough is so profuse that he eventually throws up. So he is not getting his meds down nor any nutrition. When he does manage to get something down his feeding tube, it comes right back out as diarrhea. If it is not coming out one end, it is coming up the other. He is so frail and fatigued. I plan on having him evaluated on Monday by the oncologist. He can't go on like this and may need to be admitted to the hospital long enough to build his strength up. I just don't know where we go from here. Between the cough, diarrhea, vomiting, and the lack of nutrition and medication, he is wasting away. I thought the feeding tube was going to help maintain him but he isn't even getting his Ensures down it. My Aunt tried to put a can in him today but he didn't even finish the whole thing before he had her stop. Under 200 calories for one day(plus coffee), is not cutting it.

I have spoken to the Dietician and she is supposed to be bringing a different supplement for him to try. She said it is a low residue formula and may help with absorption. I asked her if I could puree food for enteral feedings but she didn't recommend that. I just think if I could get 900 calories in him at once, opposed to the measly 350 calories, that he would be better off. I have read numerous stories of patients increasing calorie intake this way.


I am also wondering if there is anyway to control his coughing spells and severe phlegm. He said he was up for an hour and a half last night just coughing non-stop. I feel terrible for him because I know this is painful and exhausting for him.

And lastly, isn't there another way for us to keep him hydrated at home as well? Isn't there a solution that can be administered at home to maintain his electrolytes? I am thinking I need to take him back to the ER tomorrow for more fluids.

I hope everyone enjoyed Thanksgiving as best they could. My dad did sample a little of the potatoes and stuffing at least!

Much love to all.

Comments

  • Unknown
    Unknown
    #2
    This comment has been removed by the Moderator
  • Daisylin
    Daisylin Member Posts: 365
    #3
    unknown said:

    This comment has been removed by the Moderator

    feeding tube
    Just wondering, and not sure if you've ever mentioned it, but is your dad's feeding tube a g-tube? If so, perhaps you can have it converted to a gj-tube. This will bypass the stomach and feed directly into the small intestine. This way, if he vomits, he will still maintain his nutrition. I assume he has a g-tube, as you mentioned putting pureed food and boost into it.

    You would be given a special high calorie formula to put in a j-tube which has 1,500 calories. He would feed overnight, and it usually takes about 12 hours. You can also push fluids into the tube, which will help with hydration. Most medications are available in liquid form or some can be dissolved in warm water and put in the tube as well. Be sure to ask your doctor before you do try that though, some meds, such as pain relief are slow release and dissolving them could be dangerous.

    I am so sorry to hear about your dad's coughing, but I can't offer much advice, just know that we're all thinking of you!
    Chantal
  • Mazj
    Mazj Member Posts: 42
    #4
    Daisylin said:

    feeding tube
    Just wondering, and not sure if you've ever mentioned it, but is your dad's feeding tube a g-tube? If so, perhaps you can have it converted to a gj-tube. This will bypass the stomach and feed directly into the small intestine. This way, if he vomits, he will still maintain his nutrition. I assume he has a g-tube, as you mentioned putting pureed food and boost into it.

    You would be given a special high calorie formula to put in a j-tube which has 1,500 calories. He would feed overnight, and it usually takes about 12 hours. You can also push fluids into the tube, which will help with hydration. Most medications are available in liquid form or some can be dissolved in warm water and put in the tube as well. Be sure to ask your doctor before you do try that though, some meds, such as pain relief are slow release and dissolving them could be dangerous.

    I am so sorry to hear about your dad's coughing, but I can't offer much advice, just know that we're all thinking of you!
    Chantal

    So similar....
    Oh Jenny, I feel your pain and anguish and frustration. My husband has exactly the same cough I think - it sounds wet and phlegmy but nothing comes up. It's like a cross between a cough and a vomit and very scary to listen to. Some times it goes on all night until about 6 in the morning before it stops and other nights he doesn't cough at all. I am so scared at the moment because we have been waiting so long for an aspiration of fluid in his liver that his swollen legs and protruding liver have misshapen his body. He is currently asleep with his legs on 2 pillows (thanks Chantal)and I hope they go down - well just the left one this time because it is so tight that it caused him pain for the first time today and he had great difficulty walking.

    I also wonder if he has fluid in the pleural cavity. He has put on about 4 kilograms this past month but is eating like a bird and looks so thin and skinny from the waist up that I know he is really losing weight. I am assuming there will be a very large amount of fluid to aspirate tomorrow morning from the liver capsule. And then I am assuming (yes, I know what that means)that he will be unbelievably weak and still not want to eat. Because the radiologist is doing the aspiration under ultrasound guidance I don't know that I will be able to talk to him as I would to the local GP or oncologist. Things have changed so much in the past few weeks that nobody seems to be on top off it all and I am scaring myself silly watching it all unfold.

    I find it astounding that every single person on this board has their own unique story with this horrible cancer - occasional symptoms might be common but the journeys very so widely. Brian just wants to get back to fighting cancer (the secondary mets to his peritoneal cavity) and not bother about all of this other stuff that just appeared! It is more debilitating than the chemo. One theory was that when the surgeon did the exploratory laparoscopy in June he accidentally nicked something and that might be causing the fluid build up. Nobody has mentioned the word ascites to us at all - it seems to be a huge liver cyst that is growing rapidly - and nobody else has it or has heard of it.

    Sorry to high-jack your thread, it just rang such a bell with me that I couldn't pour this out quickly enough.It probably doesn't make a word of sense
    I will be thinking of you and your dad and everyone else here. Take care and know that we are all with you.
    Marilyn
  • Ginny_B
    Ginny_B Member Posts: 532
    #5
    I have often thought that if
    I have often thought that if mom didn't have the horrific cough she'd be much better. She is now on Carafate (or will be when we get the Rx filled). She was on Phenegren and Codeine, which did nothing. When we ran out I gave her Robitussin. The Radiologist also prescribed 2% Lidocaine (mix 1 tsp Lidocane with 2 Tablespoons of Malox). Mix and swallow quickly.

    The swallow quickly part was hard for mom because it's painful to swallow, so the first time she took it it numbed her mouth and tongue! The second time I gave it to her I used a straw and that seems to get it past the mouth to the throat. (It is used especially when mouth blisters form in the mouth from all the treatments).

    I keep telling my mom to close her mouth after she coughs and take are in ONLY via the nose! The cold are that comes in through a mouth sucking in air just makes the cough worse and worse. Breath only through the nose w hen coughing. My mom is a mouth breather naturally, so changing to her nose is not easy.

    Mom is 84, legally blind, diabetic, and Stage III EC. She is on continuous drip 5FU chemo via PICC line and is receiving 28 course of Radiation simultaneously. Now has to use a walker. Feeding her is always a fight. She complains about how painful it is to eat, but flatly refuses any pain medication. Chemo severely affects Macular Debeneration, so her poor sight is way worse. That' bothers her. She is also quite hard of hearing. A frail, little, old lady. It's sad to see.

    Push for the docs to focus on the cough! I pushed and pushed!

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