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[Dysphagia] XRT to neck



Apart from the many ways of dealing with mucositis,
stomatitis etc. the thick, ropy mucus is a sign of
dehydration. I bet this lady would feel much better if
rehydrated ASAP. Also, has anyone checked her for the
anemia that usually follows radiation (and chemo)?
Irene.
--- wwasmith@comcast.net wrote:

> 
> 
> Hello all,
> 
> I'm working with a 70ish lady who is s/p XRT to her
> neck area as well as chemo for lung CA.  Both have
> recently concluded.  She did not have surgery.  I
> work in rehab and surprisingly she has not had a
> swallowing eval as yet (she was admitted for
> debility following her last chemo, a downhill course
> after each one, now she can barely walk).  She is
> suffering from the usual constellation of side
> effects of both:  feeling lousy, poor appetite,
> nausea, dry mouth, coughing, retching with oral care
> and that old ropey mucous problem.    She is
> managing OK on thin lix and purees, other than her
> appetite is poor.  No s/s of penetration or
> aspiration.  No h/o pna.  
> 
> I have not treated a patient s/p chemo and RT in a
> while and am wondering what folks are using lately: 
> my old tool box included:  papaya enzyme mixed with
> food to soften the mucous,  synthetic salivas,
> avoiding milk-based products, and lots of
> hand-holding.   I recently stumbled on a website for
> LaClede oral care products:  has anyone found that
> these are soothing to patients and worth the money? 
> (I have had one patient who found that a spray
> bottle of water worked just as well).  I also read
> an article by Logemann about the need for chronic
> life-long oral and neck exercises to minimize muscle
> fibrosis.  Any comments, suggestions?  Thanks for
> any input,
> 
> Wendy   
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=====
Dr I Campbell-Taylor
Clinical Neuroscientist
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