Next up: Mucositis, a/k/a Mouth F-bomb Sores.
I’m not kidding. I wish I were, but I’m not. Three months ago, even if I had tried really, really hard, I couldn’t have made up all of this S**T (pun intended and unintended).
In case you are unfamiliar (why on earth WOULD you be familiar?), let me clarify: cancer-related mouth sores are one of the most common side effects of chemotherapy. I thought I might see them at some point, but not after the FIRST treatment.
To also clarify, “Mishegoss” is a Yiddish word that means crazy or senseless behavior. These mouth sores are crazy and senseless. Definitely.
I’ve been F-bomb’d by seemingly all things FBC so far. Silver Lining (SL): I did not have an allergic reaction to the first chemo infusion.
Back to the not-so-beautious mouth sores.
What are mouth sores (a/k/a mouth mishegoss)?
Mouth sores or ulcers (as in open wound) form on the ultra-sensitive inside lining of the mouth (mucous membranes) or on the lips (mine are both in my mouth AND on my lips, of course).
Now, these nasty things can extend into the tube (esophagus) that carries food to the stomach. Here’s a SL: mine are only in my mouth. Yippeee!
The mouth sores appear burn-like and can be painful, making it difficult to eat, talk, swallow and breathe. Yes. Yes. Yes. And Yes. …and I woke up with a mouth FULL of them.
When does mouth mishegoss happen?
Chemo-related mouth sores tend to be episodic, appearing three to ten days after a chemo treatment. Ding. Ding. Ding. Mine are right on time. Punctuality has always been a strong suit of mine. I was hoping to miss the arrival date for mouth sores, though.
Why does mouth mishegoss happen?
Well, because chemotherapy treatments are intended to kill rapidly growing cells as in cancer cells. Some healthy cells in the body also divide and grow rapidly, including the cells that line the inside of the mouth and hair follicles. Unfortunately these healthy cells are also damaged by chemotherapy.
There are a whole bunch of risk factors for mouth mishegoss:
- People who smoke or wear dentures are particularly at risk. NOT MEEEEEE! Smoking makes me barf and grosses me out. I’ve never done it. And dentures? C’mon.
- People who have a history of susceptibility to cold sores, canker sores, and gum infections. NO. I don’t even have a cavity!
- Because alcohol is an irritant and dries mouth tissues, drinking can exacerbate mouth sores. Other than a desire for a gallon-sized glass of Cristal Champagne, I am not drinking and, sadly, have not had a thing to drink other than water and smoothies.
So, even with no preexisting risk factors, they still do show up in a big, bad way.
How long does mouth mishegoss last?
These types of mouth sores usually clear up within a week or so, unless malnutrition slows recovery. The every five-minute toilet-seeking GI distress probably isn’t conducive to good nutrition, huh? Hmmm….
The other kicker: damage to the cells in the mouth makes it difficult for the mouth to heal itself and to fend off germs, leading to the potential for perpetual sores and infections. In other words, there is the possibility for for this mishegoss to stick around for the next few months. Yes, I said months. F-bomb. I’m going to be looking for some serious SL’s here!
How do we fix (evict) mouth mishegoss?
There are all kinds of suggestions. Tons of things that I can think of to do and then promptly forget (because chemo has zapped my memory to unimaginable degrees). Now, where was I? Oh, yes, everything that I need to do to evict these F-Bomb mouth sores.
- Brushing regularly, preferably after every meal.
- If brushing is uncomfortable, options include using an extra soft toothbrush or a foam swab. Rinsing the toothbrush under hot water prior to brushing to soften the bristles may help. It may be best to avoid electric toothbrushes. Nuts. I love my electric toothbrush.
- Keep your mouth moist.
- Using lip balm may ease discomfort, but choose a gentle product without chemical irritants. I wonder if lip product color matters? I do love my red lipstick.
- Avoid mouthwashes, especially those containing alcohol. Instead, you can try a cup of warm water mixed with 1 tsp of baking soda
- Eat a good diet with a variety of foods. Some vitamin deficiencies can make symptoms worse. A good diet may help the body fight off infection. This, of course, implies that one can actually EAT.
- Avoid foods that are spicy, salty, or foods with citrus acid and tomato juice. Pineapple and strawberries are often tolerated better than other fruits, and grape or apple juice may cause less discomfort than citrus and tomato juices. I’m all about the fruit smoothie made with almond milk. These are my main “meals” of the day.
- Avoid foods with extreme temperatures. DUH.
- Drink plenty of water.
- Avoid foods that are sharp, such as crackers, toast, and dry cereal. DUH. Owie.
- Try adding moist foods over dry foods, such as using gravy and sauces. Good food choices can include –- mashed potatoes, cooked cereals, applesauce, cottage cheese, pudding, yogurt, smoothies (without citrus,) soups, Jello, baby food, or food pureed in the blender. How’s that for motivating? Delish.
- Glutamine powder (mix with water and drink). Glutamine is an amino acid that serves a energy source for the gut and to strengthen colon. I’m all over this!
- Probiotic supplement rinses (which beneficial bacteria or yeast). Been taking this since I started chemo. Still waiting for the tangible positive results.
- Papaya or papaya juice. Ewwwww. That sounds like a trip back to pottyville, which I’m not about to take!
In addition to all of these super fun activities to add to my already full FBC to-do list, I have to take (by take, I mean “swish and spit”) the following medications:
Yes, it’s called “Magic Swish”. WTF? Could I make this up? You’ll note the “red, raspberry, elixir” at the bottom left. Let me just tell you that this phrase equates to “DISGUSTING”. You can’t believe how awful this “Magical” mouth medicine tastes. Just look at the color, for goodness sakes:
In addition to the “Magic Swish,” I am also taking lidocaine to numb the mouth sores enough so that I can eat. Oh that’s right, because eating is something that I really, really, really want to do after this week. However, if you’ll remember the fact that malnutrition encourages these F-Bomb mouth sores to hang around, I HAVE to eat.
The lidocaine is a thick syrupy fluid that I can either apply to my finger and then rub on the sores. …or I can “swish and spit” it to get to the mouth sores that are loitering in the back of my mouth. Yes, they have popped up everywhere. The pharmacist suggested that I dilute the lidocaine because it’s so strong, I reminded her that horse tranquilizers don’t work on me, so I’ll be “swishing and spitting” sans dilution.
Note the bottom left description of “cherry”. All I could do was drop some might big F-Bombs at the person who so ineptly described this as “cherry”. Cherries are good. Delish. Yummy. I love cherries. This is so NOT the taste of cherry. Who, exactly, names these flavors? What training do they have? Why can’t they just say, “This is really going to taste terrible, but it will help your mouth sores, so just do it”? Dumbfounding.
Well, because I needed some more side effects in my life. Great timing because I am feeling a little low on side effects…as if I might be missing some side effects.
Dizzy? Already have that. And the suggestion about not drinking while taking Lidocaine? Now, that’s just mean. I’ve already said that (while I wish for a McDonald’s Super Size glass of Far Niente) I’m not drinking. Now, I just feel tormented.
So, here we are. Swishing and spitting my way through the end of a long, long week.
There are, of course, some SL’s to this new episode:
- The medicines, though completely vile tasting, do work. My mouth is fully numb and I barely feel a thing (though I do slur as if I had that gigantic tumbler of Cristal).
- Because my mouth is numb, I’ve been able to eat a little more.
- The medicines (especially glutamine and probiotics) work on repairing the entire gut, from end-to-end. So, I’m hoping for continued improvement.
- I am making some killer smoothies that are filling and good for me.
Wishing you a SL-filled, mouth sore free day.