Oh boy. Oh boy. Things can sure change quickly on a cancer ward.
Since Tyler’s first course of chemo, we’ve been warned about the symptoms that could develop; one of those symptoms is a condition called mucositis. We were so blessed that during his first course, Tyler only had the mildest case – some annoying sores in his mouth.
While we understood that the second course could bring about worse symptoms, we never imagined just how horrible a bad case of mucositis could be. Knowing that the chemo destroys the cells lining the mouth, throat and intestines is one thing; experiencing that destruction is quite another.
On Friday, Tyler complained of soreness in his throat. Saturday, he had some difficulty swallowing his pills and food, but did so anyway.
Sunday, the pain worsened, he was unable to eat, and he began to throw up after being put on pain medicine (Dilaudid). We assumed the Dilaudid was causing the vomiting, so Monday, he had another pain team consult, and they switched him to Morphine.
We lost track of how many times Tyler has thrown up in the past 24 hours. Since he hasn’t been able to eat or drink anything since Saturday, the only thing coming up is the destroyed mucosal lining of his throat, stomach and mouth.
Mucositis causes not only constant pain, but also constant production of mucous, which keeps Tyler vomiting.
And yeah, it’s as bad as it sounds. It’s just really, really bad.
Since his counts dropped to zero on Monday, Tyler’s body has no ability to heal from this condition. He will suffer from this for the next couple weeks until his counts begin to recover.
He’s been without nourishment for several days now. His team is trying different medicines to stop the nausea and vomiting – so far, to no avail. It is critical that he stops, so that he can take his very important oral chemo (sorafenib) and so that he can receive nourishment.
Between the pain meds, nausea meds, and weakness from not eating, Tyler spent much of Monday in tormented sleep. When he wasn’t sleeping, he was dazed, vomiting and moaning.
Tutoring has been put off for the foreseeable future. He is finally asleep now after a dose of Ativan, and I hope he is done for the night (it is 2:30AM on Tuesday as I write this).
This is the condition that frequently puts AML patients on either NG tubes or TPN. If in the next day they can control Tyler’s vomiting and pain, it’s possible he can begin to eat again. Otherwise they will start with an NG tube and then go to TPN if he can’t tolerate that (e.g., throws up the tubing).
This is a new chapter in Tyler’s cancer journey, and a terrible one. He was so fortunate to get a pass on the first course.
Please pray that his medical team can find the right treatments to control his vomiting while he suffers from this condition.
He needs nutrition, he needs relief, and he needs his chemo.