2 weeks at my 2 monthly check up I had the usual throat camera examination.

I've had my throat examined this way about a dozen times before, but I was sick an hour after eating. 2 nights later I had low abdominal cramping pains that kept me awake.

As has happened once before after such an examination my throat became more and more sore over the next week. By last Tuesday and all of this week I've had a raging sore throat and was given co-amoxiclav antibiotics. The throat got worse even though my chest got better.

But this morning I felt really quite frightened when I tried to swallow water it gurgled back up and my antibiotic tablet stuck in my throat as if it was all too swollen to let any object go anywhere. Today my GP said I had a very nasty oral fungal infection/thrush and prescribed liquid Nystatin. I have to say the relief on the first dose today was immediate.

1. Have any other members been infected after a camera examination of the throat and did they also have stomach problems as well as throat infection?

2. What advice/foods/drinks do you recommend bearing in mind swallowing is a problem. Are any foods likely to cause more harm than good.

3. One especially for Vinod - how dangerous is it when you think your throat is totally swollen closed - should you head for the emergency ward or call out a Doc or hang on in there...???

Kind wishes to all.
Pauline
Pauline Thomas Worcestershire England UK

Occult Primary Head and Neck Squamous Cell Carcinoma diagnosed June 2002. Surgery for node removal plus 30 treatments of radiotherapy Sept/Oct2002.

Hi Pauline

Is there no end to what we have to endure?!!

Sorry I've no words of comfort or advice; this is just to let you know I'm taking an interest and hope it is """just""" thrush which is easily treated. My thrush (during radiotherapy and again after) was treated with Diflucan for a week - excellent stuff that got rid of it.

Don't forget a good old fashioned salt gargle if it doesn't sting too much.

As a last resort, if you can't eat anything there's always a nasal or PEG tube of course. Did you have one of those before?

Keep us posted

Steph

Hi Steph
I'm pleased to say that although still very sore, my throat hugely improved just using the Nystatin yesterday.

I am afraid I did panic somewhat and thought my husband might have to dig ane empty Biro into my neck to help me breathe. It was unlike any choking experience I have had before. Mostly you think this will clear when choking on food, but yesterday I felt it was all sealing and closing up.

I think I may have made it worse by drinking honey and lemon - but of course I did not know then it was yeast infection and the sugar would have fed it.

I am taking some of my own advice on foods (ROFL) and living off tubs of Milky Bar. They go down ok and at 200 calories a pot do feed you a little.

BTW I thought Diflucan was for the other end!!!! but I expect there are various products. Now I am wondering how long does this oral thrush last on average. I stop the antibiotics Monday night. Just don't feel I can leave them off with the green stuff that has been on my chest.

Lying in bed has been a real deja vu experience as it was this time last year I had the nasal tube etc., and spent 7 weeks in bed. No, no, no, I do not want one again. Also I have just about sorted out a winter wardrobe again having just sorted out what only seems like yesterday a summer wardrobe again.

I have lost 64 pound since June 2002. Last Christmas I got some new clothes, but still lost 18 pounds after up until April, some are still ok depending on the item, but most are useless/shapless.

I got rid of all the clothes that were 4 sizes larger in the summer, but I am hanging onto stuff a size or two larger. Fortunately as I have taught fashion courses I am very capable at altering things. Also the main bonus of losing the weight is that it really is a thrill to be able to try on things and find they actually fit. Shopping for clothes gives me quite a frisson these days.

However unlike being 4 stone heavier I find at a lower weight (now size 12) the loss of 2 or 3lbs shows quickly in fitted garment fit, whereas when heavier it took a loss of about 8lbs to notice a difference in fit. I don't miss the weight, but sometimes on shop cameras and in mirrors I think who is that - looks familiar...

If you are unable to get out and about to shop Steph have you though about shopping off the internet. Both Marks and Spencer and Next and QVC sell a wide range of clothes in a good range of sizes. And all are easy to return if housebound with walking difficulties. I often order this way just because it's nice to see things alongside existing items you have and at your own pace. It's well worth the �3 or so delivery.

Glad to hear you have survived radiotherapy.

Hello Pauline

It must have been fightening - not being able to breathe owing to the swollen throat! I would rather call an ambulance rather than use a empty Biro!

Some info (from several sorces) regarding the Fungal Infection- Candidiasis:
------
Candidiasis is typically caused by opportunistic overgrowth of C albicans. It appears that the antibiotics used during your chest infection could have altered the oral flora, thereby creating a favorable environment for fungal overgrowth.

Protocols utilizing topical oral antifungal agents appear to have variable efficacy in preventing or treating fungal infection. Several centres use Nystatin suspension or pastilles to reduce incidence of either oropharyngeal or systemic Candida infections, sometimes unsuccessfully. Clotrimazole pastilles and amphotericin oral solutions or tablets have some efficacy in reducing colonization and treating oropharyngeal infections.

Patients with superficial candidiasis should:
* Clean the oral cavity prior to administering topical antifungal medications like Nystatin or Amphotericin; irrigation and mechanical plaque removal may be necessary prior to drug dosing.
* Remove dentures while medication is being applied to the oral tissues.
* Disinfect oral tissues in addition to dental prostheses. Mix 1 part of hydrogen peroxide in 6 parts of warm water and add a dash of salt, and intraorally swish this mixture for 2 to 4 minutes several times a day. This is a good alternative to chlorhexidine.

A suspension is better instead of a pastille if xerostomia is present (if a pastille is preferred, the patient should rinse or drink water prior to dosing). Although topical antifungal prophylaxis and treatment may clear superficial oropharyngeal infections, topical agents are generally not well absorbed and are ineffective against more deeply invasive fungal infections.

There is increasing evidence that systemic azole antifungals can effectively reduce overall oral fungal colonization levels and reduce the risk of oral candidiasis, with fluconazole being the agent of choice. A frequently used protocol is systemic Fluconazole (aka Diflucan or Canestan) tablets 50 mg (or 100mg for difficult infections) daily for 7 (or 14) days.

Persistent or locally invasive fungal infection, especially when risk for systemic dissemination exists, should be treated with appropriate systemic agents. Systemic agents are thus indicated for treating all except superficial fungal infections in the oral cavity. Therapeutic doses of fluconazole and itraconazole have been reported to produce effective responses . Systemic candidal infections represent considerable risk to the immuno-suppressed patient; treatment efficacy is limited and triazole-resistant organisms may emerge. Amphotericin B is often the drug of choice for treatment of systemic candidiasis.

An increasing number of different fungal organisms are being associated with oral infection in immuno-compromised cancer patients in recent years, and includes infection by species of Aspergillus, Mucormycosis, and Rhizopus. The clinical presentation is not pathognomonic; lesions may appear similar to other oral toxicities. Microbiologic documentation is essential. Systemic therapy must be instituted promptly due to high risk for morbidity and mortality.
------

Hope that helps.

Best wishes
Vinod :coffee:

Thanks Vinod

Don't much like the sound of being colonized and am not too enthralled by words like mortality and morbididty, but I did ask.

I think I have learnt from this experience to go back to the Doctors sooner. I felt this throat was the throat from hell by Thursday.

The nystatin has been good so far. Don't think I helped any of it much by thinking what it needed was abit of tongue scraping!!!!!

What a scary experience Pauline! I can understand your fear as my neck is very very tight including the area across my trachea and I do worry in case it gets worse and I can't breathe. I do hope things continue to improve.

I, too, had a nasal tube in hospital for 5 weeks; it was more of a nuisance than anything and I was really glad to get shod of it.

Forgive my ignorance but was does BTW mean, as when you said """BTW I thought Diflucan was for the other end!""" Not come across that one before.

Yes, if I don't soon gain weight I'll have to do some internet shopping.

Keep us posted.

Steph

Hi Steph

Hope you are doing better and coping well. Hope that hip has stopped giving you too much aggro.

I still have this damn mouth thrush. It is a bit better, but certainly not gone. I will be picking up my third bottle of Nystatin tomorrow. Spoke to my Doc via the triage system and he said to keep taking it until I felt it had gone and then to take it for an additional 3 days to be sure.

I know its not helped by my oversweet diet, but I find it hard to find things I like to eat post therapy that are savoury. Shovelling the yoghurt though and have cut back a bit on sweet stuff. I see him next week so we can see if I need a different medication.

Today though I managed to eat a finely sliced whole spanish onion which I fried with one Walls pork sausage. I tried a more qulity """meat""" version of a Cumberland sausage last week, but it was too like meat. Weird - as if I had to eat a sausage in the past i would have chosen the more meaty version.

These days I need processed food more. It still only tasted mediocre. I can also eat mince pies although they taste a bit odd. I suspect that after 14 months it doesn't get much better than this taste wise. Nothing tastes like it did and I must be frank Christmas has lost much of it's old appeal as so much of it is these days is overtaken by just indulging the oral senses. I look at all the ads and sometimes now feel disgusted at all the overindulgence.

I don't think my taste has improved greatly since say month 10. But at least I can eat solid foods even if I do need gallons of fluid with it.

I can see you need a net dictionary - suggest you look up a phrase such as internet acronyms or phrases in www.google.com otherwise here are a few that are most used for starters.

BTW by the way.
IMO in my opinion
IMHO in my humble opinion
ROFL rolling on the floor laughing
LOL laughing out loud
FWIW for what it's worth
DH dear husband / darling husband
BRB be right back
TTYS Talk to you soon
Hope this helps. Best wishes Pauline

Hi Pauline & all

Guess what Pauline! I, too, have thrush again so started on the Diflucan med. today - that usually clears it up in a week. Thanks for the net dictionary - I knew them all except BTW and DH.

I'm on a liquid diet - mostly Build up soup, Fortisip (sweet), Scandishake (sweet) and porridge and am craving for more savoury things, although I do have the occasional ordinary soup.

I've been extra sleepy today - didn't get up until 11 am and was back in bed by 1pm till 4.30pm.

Had rather a scare earlier. I picked up a paper to read and my vision had gone to pieces. My eyesight straight on was fine but my peripheral vision was sort of fragmented and moving about. It stopped for a while then came back later. It's OK again now but think I'd better see my doctor or optician (not sure which is best). Of course I get paranoid about everything now especially after finding that lump on my temple (although the hospital did say not to worry about it).

My sweet taste buds seem to have been destroyed. I'm drinking a chocolate Fortisip right now - doesn't taste much like chocolate!

Hoping to get a wheelchair soon so hubby (Roy) can take me out and about. Roll on April when they can repair that damn hernia in my abdomen.

Love and kind thoughts to all
Steph

Hi!
I live 6 km. from Walkerton, Ontario, Canada. Everyone knows where that is, right?
Have read all the posts with so much interest.
Please tell me- on an average, how long does it take for thrush (caused by radiation) to clear up, if one is using Nystatin, a mouthwash of salt and/or peroxide etc.
How long until the taste buds come back?
Please reply......anybody.

Lynda thrush is a damn pain. I've been scoped at my check up today and am confident the nasty little fungus will invade me in the next week. I find nystatin is just a comforter as it is a soothing liquid to swill the mouth. I usually have it with diflucan or flucanozole.

I have also had Daktarin gel prescribed which can also be bought at the chemist here and that is also instantly comforting like nystatin is. Just make sure it is the oral version not foot version!

Most of these products are the same basis but I prefer diflucan tablets for 2 weeks to get shot of it. You should have a vague sensation of taste in 3 months post rads. Don't overestimate what I mean by vague. It's 2 years since my rads finished and taste is still up and down. I've had limited taste for a month and lost 3 pounds at my hosp weigh in today.

But in June - August my taste buds were much better. The only thing comparing notes here seems to have achieved is that taste is an up down situation ever after. Taste wise some days good, some days are bad. It's very much wait and see, but most people do get an element of taste back enough to survive. However I take the view I'd rather have no taste than be dead.

HI EVERYONE I have joined the Thrush breakout, started a treatment and while in France it cropped up again and I could not get any treatment; so it is a must when travelling abroad to go fully equiped.
Big Bear Hugs

Hi I too have joined the thrush club. Am on diflocan so hope it clears up soon. I have had a sore mouth tongue teeth and earache. Is this common with thrush or could it be something else? My GP didn't sem to know.

Thrush is back again,so may ask the doc for something better, doing mouth washes, cleaning teeth, a real bore; when I was going through the thick of things, rad etc, I did not have thrush, keep me posted for a real cure that will liberate me from this problem.
BigBearHugs

Hi Lynda,Thrush is due to your immuine system being suppressed and it could take three weeks or longer to clear up.Continue your treatment and eat healthy foods if you can. Taste buds are damaged by radiation and come back slowly. Salty and sour tastes come first followed by sweat taste as long as a year later. I was always delightfully surprised when a loved food finally tasted right.
Cathy

Garance sometimes you need not just one week, but 2 weeks of the Flucanozole treatment. I only have 2 prescribed now as one appear to be a waste of time.