Questions from a caregiver

Alexandra said:

Dear traveler1959

I am very sorry about your wife's situation. Unfortunately what you are describing is very common in women with late stage recurrent ovarian cancer.

Breast cancer after ovarian in relatively early age (I'm assuming she is in her late 40's or early 50's) is less common and makes me wonder if your wife has been tested for BRCA gene mutation. If she was not and she has kids or siblings, get her tested for their sake to confirm (or rule out) hereditary cancer.

Complete or partial bowel obstruction could be caused by a new tumor or by adhesions from previous abdominal surgery. Bowel obstruction is usually treated at the hospital by inserting NG tube that removes fluids and gas and helps relieve pain and pressure. If intestine is completely blocked sometimes it requires colostomy or ileostomy.

If she experiences severe symptoms accompanied by occasional vomiting after eating solid foods, you will need to avoid all solid foods for a while and follow a Liquid Diet. This diet can be poor in energy and various nutrients. If she needs to be on a Liquid diet for more than 5 days, ask your dietitian about nutritional supplement drinks and the need for vitamin/mineral supplements.

Fluids (http://www.bccancer.bc.ca/NR/rdonlyres/01B68B82-61CD-45A4-B71D-37A5A1318453/55937/LowFibreFoodChoicesPartialBowelObstruction.pdf)

·         All fruit juices

·         Fruit flavored drinks

·         Carbonated fruit juices (flat, let the gas out)

·         Resource Fruit Beverage ® (clear fluid nutritional supplement)

·         Ice tea

·         Soda pop (flat, let the gas out)

·         Jell-O®

·         Jell-O® made with juice

·         Popsicles/ Juicesicles

·         Clear broth

·         Bouillon

·         Consommé

·         Coffee

·         Tea

·         Herbal Tea

·         Clear hard candy

·         All dairy beverages such as milk, chocolate milk, buttermilk, goat’s milk, plain milkshakes

·         Ice-cream, frozen yogurt bars

·         Sherbet, sorbet

·         Plain or flavored soymilk

·         Soy milk based shakes

·         Plain or flavored yogurt

·         Milk puddings, yogurt drinks

·         Steamed milk, Café au lait

·         Carnation Instant Breakfast® drink

·         Ovaltine®, Horlicks®, Postum®

·         Hot chocolate with marshmallows

·         Nutritional supplement drinks

·         Eggnog, custard

·         Jello made with milk or ice-cream

·         Fruit nectars

·         V-8 juice, tomato juice

·         Strained cream soups

·         Cream of wheat

·         Cream of rice

·         Well-cooked oatmeal

For partial bowel obstruction it is best to eat small frequent meals and to avoid foods that result in gas and bulk in the intestines. This means that avoiding fiber-rich foods such as whole grains and raw fruits and vegetables is essential for a patient's comfort and proper bowel function. The amount of fiber restriction depends on the severity of the obstruction. It is important to try to continue to eat fruits and vegetables. However, they must be low fiber/low residue, which typically means they should be cooked, canned, and/or free of skins and seeds. Pair the choices below for a well-balanced snack.

Some examples of high-protein, low-fiber snacks appropriate for most partial bowel obstructions:

·         Yogurt, particularly Greek yogurt

·         Cheese with white bread or crackers

·         Smooth nut butter with white bread or crackers

·         Smoothies made with pulp-free fruit juice, yogurt, and whey protein powder

·         Drinkable yogurt

·         A hard-boiled egg

·         Smooth oatmeal or cream of wheat made with milk instead of water

·         Canned tuna on white bread or crackers

 

 To maintain intake of phytonutrient rich fruits and vegetables, add these low fiber/low residue options to the snack ideas above:

 

·         Cooked vegetables such as carrots, winter squash, sweet potato (without skin), or pureed cauliflower

·         Canned fruits in natural juice

·         Peeled apple or applesauce

·         Ripe bananas

·         Mashed avocado

·         Honeydew, cantaloupe, or watermelon, with all seeds removed

·         100% fruit/vegetable juice without the pulp

 

Hope that helps and best of luck to both of you,

Alexandra

I have nothing to add to Alexandra's very complete and detailed lists of food and drink but please know that I am praying that your wife finds some relief.  She sounds very strong and you sound like a very caring husband and caregiver.  I know how fortunate I was to have a spouse at my side, "in sickness and in health".

Sending lots of prayers to you both.

Kelly