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Thread: food won't stay down, spitting up mucus

  1. #1

    food won't stay down, spitting up mucus

    My mom has SCLC-ED, and has opted out of further treatment and is under in-home hospice care for about 3 weeks. She did 4 rounds of carbo/etoposide this summer, cancer began to grow again shortly after completion. She tried to do more chemo, but her condition just didn't allow it.

    Here's the current situation: She's been admitted to the inpatient hospice unit this week after a very severe episode of shortness of breath (SOB is normal for her, this was EXTREME) and that is stabilized now back to her typical level. But now, she can't keep food or water down, she is continually spitting up mucus (every couple of minutes). She's fully alert, on morphine (1ml every 4 hrs) and ativan. She has a lump at the base of her sternum and she gets pain in that area. Sounds to me like cancer is pressing on her esophagus, and honestly the nurses in the hospice unit don't know how to help her. She's just fighting so hard, and two days ago they thought she only had two days....

    Anyone ever see this happen or know if there's a way to help manage that? I asked the nurses to up her morphine but I'm not sure they took me seriously.

  2. #2
    Super Moderator Top User Hope2012's Avatar
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    I'm sorry to hear things have progressed to this. Is she on anti nausea medication as well as morphine? If she's in hospice I don't think they will do much else other than pain control. I'm not sure what inpatient hospice entails, but are there any doctors there you can talk to? I hope you find a way to make her more comfortable.
    This dark night shall end and the sun will rise again...
    Believe

    - Dad diagnosed in 1992 with primary bladder cancer
    - bladder removed and new one made from resected intestine
    - chemotherapy regimen started
    - mets to large intestines discovered in 1993...more chemo...tumors disappearing
    - complained of neck pain Dec 1994. Mets to brainstem confirmed
    - passed away Feb 24, 1995

  3. #3
    Top User april51's Avatar
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    I am so so sorry. Some people have more mucus, I am one of them. It's been that way all my life. I do know that my gag reflex is much more sensitive since the chemo. I keep the nausea pills ready. Sometimes if the mucus gets in my stomach when I sleep it will make me sick also. Hospice will generally bump up the morphine as the patient progresses in the death process as they don't want them to be uncomfortable. Again, these are general guesses, but she will start to sleep more and eat less with or without the drugs. That is how it goes in the end. As long as she is not restless and in obvious distressful pain they may just keep her comfortable.

    If she is alert talk to her. Let her know it is okay to go.

    Again I'm so sorry. a
    May The Odds Be Ever In Your Favour. Born 1960. Diagnosed 4/2011 with one tumor, LUL, NSCLC. Tumor size 1.1 inches. Thoracic surgery 6/1/2011. No action taken. Eight weeks of radiation and chemo. Carbo and Taxol. Follow up with four rounds of Carbo and Alimta.
    December 2011 CT scan shows all clear.
    April 2012 CT scan shows all clear. July 2012 had several x-rays taken at the chiropractor for shoulder pain. Took them to the onc and nothing suspicious noted. See them again in Oct.
    October didn't work out. Pain in the left shoulder continued to worsen and lymph nodes in the supraclavical swelled so I called the onc and they bumped the regular scan up to September 19 and we went for the results on the 24th. The tumor is back and the spread is extensive. Option 1: Try targeting chemos that may work and then on to clinical trials. These would give me about a year or so if the cancer responds. Option 2: Do no treatment and let nature take its course. This will give me six months give or take. As good as I feel right now, Iím going for door #2 and will continue to live well and enjoy myself until I donít. Iíll keep you posted. Live it up everyone!

    7 months into hospice and palliative care. It has been a very good relationship with the organization as a whole with a minor glitch. April 2013 spent the night at hospice facility, PICC line inserted for morphine drip. I said I wouldnít but, had a hospital bed delivered. Started 10 rounds of palliative radiation to shrink the neck tumor. Busy month for me!

    I've taken a couple of nasty falls this last week. (first of & mid-May) Right on the cancer shoulder. So I have a life alert necklace on me now. I wish I could get my hands on a small scooter!

    There is another node swelling on the other side of my neck. Still small.

    April51's (Jody) daughter posted that her Mother's journey in this world had ended on July 8th 2013.You touched so very many lives. Soar high Jody!

  4. #4
    It's crazy how alert she is for how poorly she's doing. She's always had some acid reflux and this is that times 1000 if you know what I mean! She's had some nausea meds without any relief either. At first I thought she was coughing this up from her lungs, but now realize she's spitting it up, takes one sip of water, and up it comes. Clear, thin, frothy. She's just so close, but still so far. So alert that telling her to let go seems almost absurd really, she's a little mildly delusional now (in denial) saying that her severe respiratory issue this week was because she had a sinus infection that moved to her chest. This is a woman who is typically very medically knowledgeable and aware. For her to say that, I barely knew how to react. It's just so surprising how alert and aware (albeit a little delusional) she is on morphine. My only other experiences with morphine I would have expected her to be out of it more than she is. She's not even 90 lbs! Thanks for the suggestions and for listening. I know hospice won't do much but just don't understand why they won't at least make her less aware....

  5. #5
    Top User april51's Avatar
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    Hospice will do there job. Trust them. I have never heard of a "bad" hospice. She needs to know it's okay what she is feeling.

    You don't need to react. Just be there and comfort her.

    I've got news for everyone, when my time comes I am going out giving instructions. It will be hard to get me to calm down and go...Maybe mom is like that. Talk to her. Talk to her until you both fall asleep.

    Mom obviously needs to be aware for her own sanity. Let her have that.

    I love you and what a joy it is to be with one who is leaving this place. a
    May The Odds Be Ever In Your Favour. Born 1960. Diagnosed 4/2011 with one tumor, LUL, NSCLC. Tumor size 1.1 inches. Thoracic surgery 6/1/2011. No action taken. Eight weeks of radiation and chemo. Carbo and Taxol. Follow up with four rounds of Carbo and Alimta.
    December 2011 CT scan shows all clear.
    April 2012 CT scan shows all clear. July 2012 had several x-rays taken at the chiropractor for shoulder pain. Took them to the onc and nothing suspicious noted. See them again in Oct.
    October didn't work out. Pain in the left shoulder continued to worsen and lymph nodes in the supraclavical swelled so I called the onc and they bumped the regular scan up to September 19 and we went for the results on the 24th. The tumor is back and the spread is extensive. Option 1: Try targeting chemos that may work and then on to clinical trials. These would give me about a year or so if the cancer responds. Option 2: Do no treatment and let nature take its course. This will give me six months give or take. As good as I feel right now, Iím going for door #2 and will continue to live well and enjoy myself until I donít. Iíll keep you posted. Live it up everyone!

    7 months into hospice and palliative care. It has been a very good relationship with the organization as a whole with a minor glitch. April 2013 spent the night at hospice facility, PICC line inserted for morphine drip. I said I wouldnít but, had a hospital bed delivered. Started 10 rounds of palliative radiation to shrink the neck tumor. Busy month for me!

    I've taken a couple of nasty falls this last week. (first of & mid-May) Right on the cancer shoulder. So I have a life alert necklace on me now. I wish I could get my hands on a small scooter!

    There is another node swelling on the other side of my neck. Still small.

    April51's (Jody) daughter posted that her Mother's journey in this world had ended on July 8th 2013.You touched so very many lives. Soar high Jody!

  6. #6
    I never did get to the bottom of that 'spitting up' symptom. But things changed quickly in many ways. They did indeed finally switch her to a morphine drip saturday night after another one of her horrible respiratory episodes, and that helped ease her into the final stage. She was happy, laughing and eating (but completely hallucinating the whole time) until Monday night. tuesday she did not regain consciousness and passed at 1PM. Rest in peace mom....

  7. #7
    Super Moderator Top User Hope2012's Avatar
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    I am very sorry to hear this news, but it was good to hear she wasn't in pain as she progressed into the final stage. There is a little solace in that she seemed to pass peacefully. My condolences to you and your family.
    This dark night shall end and the sun will rise again...
    Believe

    - Dad diagnosed in 1992 with primary bladder cancer
    - bladder removed and new one made from resected intestine
    - chemotherapy regimen started
    - mets to large intestines discovered in 1993...more chemo...tumors disappearing
    - complained of neck pain Dec 1994. Mets to brainstem confirmed
    - passed away Feb 24, 1995

  8. #8
    Super Moderator Top User
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    Dangergirl, My heartfelt condolences to you and your family. I am so glad she was kept comfortable in the end. My prayers are with you. God Bless.
    Irish
    Irish,
    Caregiver to my Dad, who was diagnosed in June 2010 with Stage 1V NSCLC with single met to brain,
    He sadly lost his battle in August 2010 and we miss his smiling Irish blue eyes terribly.
    My Dad's story:
    http://www.cancerforums.net/threads/...th-how-he-died.

 
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