Wednesday, December 8, 2010

It's Still All About The Food

(NOTE: If you are seeing this on Facebook, please click below to see the entire post or go to my blog itself. I don't always make my point in the first paragraph, which is all that shows up on my Facebook page. I mean, if you actually want to see it all :).)

I'm posting this to both of my blogs, and those who only follow ChiaChatter will have to go to yesterday's post to see details of my recent surgery, if you want to get up to speed.

Thinking of how I am now eating, food is still my passion. The big difference is, how can I make my miniscule (2-3 Tbsp) meals a little more interesting, especially given my current limitations? Especially since I have to eat so freakin' many of them to get even a minimum of nutrition into my system...

My doctor has said that I can eat anything except bread, raw veggies, and - oh, I can't think of the other thing, but I won't be eating it anyway. Because he instructed me only to avoid those 3 areas, and chew well.

But before I had the surgery I did ALL kinds of research, from pdf instructions sheets of other docs who do the procedure, to medical sites, to a forum especially for fundoplication patients. And the vast majority, in talking about getting back to regular food, have much more specific instructions or experience. So, because the failure rate of this surgery is so high, and because the side effects can be disastrous, I am electing to collect all of the knowledge I gained, and create my own plan based upon the most conservative and logical of them all. I want to have the best possible outcome with the fewest possible post-surgical issues, and feel I need to be my own best "meal planner". It seems to me that most of those who are living with awful lifetime side effects or have had to repeat the surgery didn't go the most conservative route. I may be wrong, but this is how I am proceeding.

24 hours after surgery I was put on clear liquids. 48 hours post op I was put on full liquids. This includes things like yogurt and custard. The first day I ate only yogurt. I could only eat a couple of bites at a time without feeling uncomfortable, so I nibbled at it all day. The next day I included a few bites of cream of wheat with butter (yeah, they consider that liquid), and my doctor said that if I wanted to try soft food, he would change the order. So Saturday I tried some tilapia. The kitchen sent up rice with it though, and I put a few grains on the tip of my fork. Big mistake, lots of pain. I walked as far as I could to help things pass.

I think I need to insert here that my esophagus is considerably smaller than it was where it empties into my stomach. Stuff can get stuck. I have to eat taking tiny (1/2 tsp) bites, and chewing my food to a liquid consistency. I cannot drink more than a few tiny sips while eating (google "dumping syndrome"), or for 30 minutes before or after. Any foods that are hard to digest (including fiber), have skins, or seeds, or nuts, or cause gas, or could swell after swallowing or are carbonated - all off limits for now. So I need to get the maximum nutrition into the minimum intake, and the maximum hydration into the minimal time I have between the tiny meals - while observing the above cautions. Should something get stuck, I can take small sips of very warm (can't have anything very hot or very cold either) water and try to walk it off.

The problem on Saturday evening was that I was in the throes of pneumonia, weak as a kitten, and could only walk a short distance before becoming wobbly and winded. But it did pass, and I decided I would wait a few more days before trying soft or softened solid foods again.

Sunday I continued with yogurt, and added custard. Monday morning before my discharge I ate half of a scrambled egg. Introducing only 1-2 "new" foods a day is part of my conservative dietary after-care per one of the instructions sheets I'd read.

I was still living with a lot of pain when I was discharged, and no appetite to speak of. The hour+ ride to my sister's left me very weak; liquid lortab helped with the pain. I added both applesauce and cottage cheese to my diet that evening without a bad result.

Yesterday I got a little experimental, and discovered that 2 spoons of plain full fat yogurt with 1 spoon of applesauce, sprinkled with cinnamon, and stir in a drop of liquid sucralose - creamy apple pie in a dish! This was my first really enjoyable dish. And for supper, a small piece of leftover potato, put through the chopper with some milk and butter until creamy and smooth, and heated. Who would have thought that a leftover potato could taste so amazing??

Today I had some SF jello with a scoop of cottage cheese that lasted me for several hours (about 1/2c total). Just now I took some of my broth that I'd saved up from my pre-surgical meals (frozen), and heated it with a chunk of butter, then mixed in a few mashed potato flakes to thicken. I let it sit for quite a while to make sure the flakes were fully "inflated" before I ate it. In fact I am still eating it, and it will last throughout the evening most likely. It was delightful to taste my own seasonings again.

So it is all about baby steps - and baby bites! - and patience and listening to my own body. If my stomach starts sending out the "full" message, one more bite will cause pain. And today is the first day I have really felt hunger. To me this is a good thing, a sign of healing. So many people are unable to burp or vomit after this procedure that these issues are to be almost expected, although I have been able to burp a few times. And life of flatulence will also be a result. Lots and lots of flatulence...

Whereas before I took great satisfaction in a delicious plate full of food, in creating an entire glorious meal, now it is much more simple - just blending a couple of flavors to keep the boredom at bay, and the anticipation and even excitement of adding in a new food every now and again.

Everything will be different from now on. But given what I have suffered the last 19 years, progressing to what it became the last few (my husband, daughter, and sister are really the only ones who know the extent of that), this is a small price to pay to get my life back. As time goes on it will become natural, and I will also be able to eat more normally. Doc says a year to heal completely, the first 100 days will be critical. And it is these 100 days that I don't want to do anything to mess it all up. Baby steps, slow and steady...and simple pleasures like apple pie in a bowl where I can find them :).