18 Jun 2012

Weighing In

We've all felt the shock (and fear) of seeing an extremely emaciated person at the cancer treatment centre.  With ovarian cancer, there are many reasons for severe weight loss including complications from surgery, intestinal blockage, ascites, disease encroachment, chemotherapy side effects, pain and depression.  Our tabs on Advanced Disease and Advanced Disease Dietary Help give an in depth description of the more notable causes.

Putting on weight during illness is as daunting as dieting and is equally frustrating for the patient and their families.  A "healthy" appetite is viewed as just that - healthy. Oncologists have reported that some of the most stressful times in a patient's journey is when their spouse or loved ones interpret their lack of appetite as giving up - an unwillingness to live. 

Whether you're being weaned off TPN or recovering from a bowel obstruction, knowing that you must put weight back on is challenging, a bit scary and requires diligent work.  Not regaining  weight weakens your immune system, puts you at added risk for osteoporosis, causes nutrient deficiencies and will ultimately lead to disease progression. 

Theoretically, one needs to add 500 calories a day in order to gain one pound per week. 32 years ago, when my mother was originally diagnosed with breast cancer, she was told by her doctor to eat everything and anything she wanted.  He told her to choose cream over milk, butter over margarine.  Today, we think we're a little wiser (maybe not!)... remember being taught the difference between good and bad calories?  Also be reminded that cancer thrives in an acidic environment so try to choose the majority of your foods accordingly.  Here's a chart outlining foods which are alkaline and those which are acidic:

Normally, a patient's healthcare provider should guide them as to what form of food is appropriate - i.e. if you're post-bowel blockage or surgery, you would be encouraged to start with juicing and purees rather than raw foods.

Here are some basic suggestions for regaining weight:
  1. Plan and count your calories.  Make every mouthful count.  Livestrong has a neat calorie counter app for either wanting to gain or lose weight.  It will calculate your ideal weight, let you search their library to see the caloric benefit of millions of individual foods and help you track your progress.  http://www.livestrong.com/thedailyplate/  Check out the site before preparing your shopping list.
  2. Start slowly and eat/snack six times a day.  Overwhelming yourself with large meals can be harmful and discouraging.  Additionally, carefully planning scent and taste can make a significant difference in stimulating your appetite.  I remember my own emancipation from the "feed bag" - having been nourished with a completely balanced liquid (TPN) for ten days following surgery - then with the flick of a switch returning to solid foods - was very confusing and more than a bit frightening. 
  3. Add healthy fats such as nut butters, avocado, omega 3 oils.
  4. Make liquid calories count - choose 100% fruit drinks.  Wine is a fruit drink and an appetite stimulant!  Don't be afraid to revert to a food supplement drink in lieu of a snack.  Freeze it in a popsicle container for variety.
  5. Be consistent - keep a journal - write down what you've consumed and add it up each day.
  6. Include exercise...it builds muscle, increases your appetite, helps with chemo fatigue and improves your mood.
  7. Go easy on yourself...leave a little room for a treat!
Educating caregivers is essential in supporting patients with weight loss "whiplashes".  The speed of the decline can be alarming and the recovery can take time.  In cases of very advanced disease, recovery is not always possible - this too, requires special understanding.

1 comment:

Karen Ingalls said...

Such good, necessary and often overlooked information. Thanks for sharing this.