Hullo April. Sorry to hear it's such a **bleep**-show. But nobody tells us cancer will be fun 😕 Yeah, the mucositis is .. yuck. And it takes a while to go away .. I read a patient study where the aggregate was about 8 weeks. I'm 2 months out of therapy, and it's gone down a lot, but I still have it. Nasal intubation: this is generally meant to be temporary, and they say it's demoralising to have a big publicly visible tube running out of your nose, and all those well-meant sympathetic looks or awkward eyes averted .... (that wouldnt bother me, but I'm weird). Personally, as soon as you struggle to take nourishment by mouth, I'd consider it .. but also ask if a PEG is viable. If you assume you're going to have at least 9 weeks of mucositis, then maybe that length of time (or longer) would justify the minor surgical procedure. How much nutrition do you need: this is an important question. I started my treatment obese, and the dieticians were real nazis insisting "YOU MUST NOT LOSE WEIGHT DURING THERAPY", but if you look at pubmed and other scholarly and respected sources of information, if you're already obese (or heavy), it's OK to lose weight over therapy, it doesnt undermine the clinical outcomes. So if they've said take 4 litres of formula a day, that might be based on getting 120g of protein and 1600 calories or something ... whereas with other strategies you might be able to reduce the (traumatic) intake. If you're not heavy, well you do need to try and maintain weight as best you can, but if you are, the priorities should be (in this order & in my opinion): hydration, protein, nutrition, calories - high protein whey shake .. with two small shakes you can get 70g protein per day (.5 litre ish) - hydration: no way around it, you need to chug a couple of litres of water per day - nutrition: a few sustagen shakes per day (250ml ish) should sort you out - calories: make your shakes with milk, not water ... and also, if you get a blender, think about popping down to Woolies and buying one of those premium yoghurts .. 600g thick yoghurt mixed with mango or whatnot .. I cant remember the name, but 1 tub is 1000 calories .. if you mix that into a blender either alone or with your formula, it liquifies quite well and you can drink it down for more calories per effort If I were you, I'd have a careful talk with your dietician(s) and work out the best bang for your buck approach to consumption, and make sure they aren't giving you skewed advice. My experience with pain: now, 2 months out, I'm not even taking panadol any more - but I think pain management started about week 6 or 7 (at first just panadol, but ramped up to the endone and morphine powder in week 7). In my experience, the pain was at its worst in the first couple of weeks after therapy. I still have pain now, but it's like a kind of perpetual sore throat, nothing I can't live with. The thing about the pain is ... know that it's temporary. It may be bad today, it may be bad tomorrow, but in 2 months you will have forgotten it (it's a little like having a baby, we tend to forget the immense pain once it's gone, which psychologically allows us to then go and have more babies). Other comment on pain: ramp it up. If you're experiencing pain without relief, just ramp it up. The pain relief is there for a reason, don't suffer through it. Although morphine is addictive, if you're using it to treat genuine pain, you're fine. My quack urged me to ramp up the pain management, and I did so reluctantly (because my mother is a heroin addict, so I had some genetic familial concerns), but he urged me to use it, it's what it's there for.
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