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Post-treatment Feeding

DrMary's picture
Posts: 522
Joined: Nov 2010

I was going to post this on the caregivers list, but it is really H&N specific. Doug is now 3 days post-treatment - he skipped the g-tube, as he could eat reasonably well until the 2nd chemo, which kicked the crap out of him. He lost 35 of his 175 pounds and so now we are trying to build it back.

He can drink thin milkshake-type liquids - Boost Plus is about as thick as he likes. We're up to about 2600 calories/day and about 135 g of protein/day with 4 Boost Plus, 1-2 milkshakes (Bluebonnet Whey powder, glutamine powder, milk, cream and vanilla syrup) and little bites of whatever we have for family meals. I'm also supplementing with an Mg, K, P, Ca and B3 liquid that I get from our local wholefood-type store. I've been making cream of everything soups - at the moment, his throat is still a bit raw and he has tongue sores, so many of those are not going down well - the problem seems to be the fiber, but sometimes also the acidity (like with tomatoes or peppers) gets to him. . . or the texture. . . or the taste (his stomach is still a bit touchy). So, he can swallow things like macaroni and cheese, but it' slow going. Mashed potatoes are a bit rough, still. He's not good at just sitting and eating all day - already he complains about feeling useless when he only gets a few hours of work done in a day.

So, suggestions? I've been looking into maltodextrin as a way to get more liquid carbs into him (he's a jock and I suspect his body is not used to having so many of his calories come from protein). How much can you mix into a liquid before it gets thick? Nestle's Glutasolve looks interesting, as a way to get glutamine and maltodextrin into a drink, but it's pricey and I've found no one who uses it to let me know whether it's drinkable.

Am I being too conservative on the protein? I'm seeing some muscle growth in him already, but his weight is not really increasing yet. (I should mention that, since he went almost 3 weeks without eating, we started out slow, on a refeeding protocol, and worked up over a week to the current level.)

It sounds like many of you are old pros - thanks for the advice!

Scambuster's picture
Posts: 973
Joined: Nov 2009

Hi Mary,

Sounds like Doug is doing well considering. This can be the most difficult time and one where many go into a bit of a depression due to the slow improvement, pain and general post treatment crash and burn so keep an eye on him.

For the Mouth burn, I would recommend have a glass of water with a heaped spoon of the glutamin powder on hand at all times as it will neutralize the burning from various foods he will try. This could last a few more weeks.

I wouldn't be too concerned about the protein as we don't need as much as we've been told and too much is not good for cancer patients. He will only build muscle if he is doing resistance excersices. He can start with light exercise like push-ups and sit-ups and walking, biking if and when he feels up to it.

The variety of nutrition is more important now as he is healing. It may take a few more months before the weight starts to come back on. Focus on getting all the best nutrition, enzymes, and anti-oxidant rich foods. I used supplements to boost the levels of antioxidants including: Vit C, Omega 3 complex, CoQ10 Coenzyme, Alpha Lipioc Acid, Resveratrol, and many more. The Zn is good for healing as is Mg and Selenium. You might find a good 'Immune booster' in powder form with some czarbs and protein which he can get in easier than taking capsules.

I started eating with a rice soup, which I could swallow with minumum mouth action(hence pain) required, and I slowly built back up from there. Soft tofu was good, some softened beans, lentils later.

It can take a while to pass through this difficult stage. Hope these few tips help.


D Lewis's picture
D Lewis
Posts: 1576
Joined: Jan 2010

Honestly, I believe my body had to heal internally before I could use the extra food/energy to gain any weight. It's been six months, and my weight is finally beginning to increase.


scottied's picture
Posts: 34
Joined: Nov 2010

Something you may want to try is a protein shake that is high in carbohydrates instead of just protein. Protein is good for feeding and rebuilding muscle if your working out but carbs help you put on weight regardless. The mix i used was this http://www.bodybuilding.com/store/opt/gainer.html I would use the banana cream pie and the vanilla flavor, both tasted very good. Another thing i was told about was glutamine I was told that if I had been taking it through treatment i probably wouldnt have lost any muscle mass. I was told it directly feeds your muscles. One scoop is about the size of a water bottle cap and you mix it with 4oz or more of water. Can take it as many times a day as you like. http://www.gnc.com/product/index.jsp?productId=3978770&cp=3593186.2108321.2102385 I hope this helps.My last treatment was christmas eve last year and I had lost 35lbs of 215lbs. I was back to my normal weight in about 7 months. I can say that no matter what i was taking i never felt as good as i do when i am eating regular food. I was eating nothing but regular food probably about 4 months post treatment. One other thing, I was prescribed Megace for appetite and the stuff works wonders. This is just my results as you know everyone is different with their recovery. I hope this helps.

Good Luck

Hondo's picture
Posts: 6643
Joined: Apr 2009

Sometimes we need to do what we need to do to keep the old body going till the treatment stops. My first treatment I lost almost 47 lbs I had no PEG tube and how my wife got anything in me is still a mystery to this day.

DrMary's picture
Posts: 522
Joined: Nov 2010

While I'm certain your wife is a saint, you don't give yourself enough credit. To keep trying to swallow things when: A) you are not hungry; B) it hurts to swallow; C) you throw up half of what you swallow and that hurts even more; and D) it's just SO much work - that's the stuff of champions.

Posts: 2
Joined: Nov 2010

You're doing amazing it sounds like. Could you tell me if you plan to see a swallowing specialist? I work with them - on this issue and always helpful to know if you get referred.
They're usually SLP's - speech and language pathologists. Best of luck.

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