High Calorie Supplements - Malnutrition

[GarryP]

My wife is suffering from malnutrition as a result of cancer of the tongue. She has been in remission for 4 years now but as a result of surgery and radiotherapy, she sometimes has problems swallowing solid foods. Part of her tongue and neck was removed and radiotherapy resulted in considerably reduced saliva production (she is one of the lucky ones as many patients end up with little or no salivary function at all). She tries her best to eat but with a few recent incidents of food being stuck in her throat resulting in choking, she is getting more and more scared of eating even semi hard food. Compounding everything is her difficulty in expectorating phlegm, leading to breathing difficulties at times.

She is eating food supplements like Ensure and Neo-Mune, but it is just not enough. She needs to greatly increase her calorific and protein intake as she really needs to increase body mass and boost her immune system.

Any suggestions as to liquid or powdered supplements that are available in Thailand, or other alternatives would be greatly appreciated.

NB: This is causing great stress to me and my son watching a great wife and mother waste away. Suggestions of taking my wife to the hospital or doctor are not sought. She will not go and although I disagree with her position on this, I certainly understand it after what she has been through.

[A1Str8]

Don't feed her with powdered supplements and similar. Processed food would just make things worse.

Use real food. Get a food blender and blend everything. It sounds gross but it is irrelevant in her case.

Vegetables, fruits, some good fats in the form of olive oil etc, peanut butter, fish and all kinds of meat for protein. Oatmeal, sweet potatoes etc for carbs. Just cook it blend it and tell her to drink it. She will get used to it. And it is more beneficial than any supplements out there. Plus cheaper if that's a concern.

All the best to her and the whole family

Sent from my GT-I9500 using Thaivisa Connect Thailand mobile app

Edited May 5, 2014 by A1Str8

[h90]

Beside beef (or pork) soup with egg and maybe blended potatoes inside (taste good), what about bodybuilder food?

There are these mass builder protein/carbohydrate shakes. Of course she wouldn't like it in the quantities bodybuilder use it. But a glass of normal milk with it, taste like cacao just between instead of drinking water?

A friend of mine ate Astronaut food for a while, it was creme like and contains everything needed. Unfortunately I don't know more about it, maybe someone else does?

Sheryl: I know from professional bicycle racer that they are over night on some intravenous food supply....would that help? I don't want to post something misleading, maybe you know?

[h90]

Don't feed her with powdered supplements and similar. Processed food would just make things worse.

Use real food. Get a food blender and blend everything. It sounds gross but it is irrelevant in her case.

Vegetables, fruits, some good fats in the form of olive oil etc, peanut butter, fish and all kinds of meat for protein. Oatmeal, sweet potatoes etc for carbs. Just cook it blend it and tell her to drink it. She will get used to it. And it is more beneficial than any supplements out there. Plus cheaper if that's a concern.

All the best to her and the whole family

Sent from my GT-I9500 using Thaivisa Connect Thailand mobile app

"Processed food would just make things worse."

Nonsense!

[GarryP]

Beside beef (or pork) soup with egg and maybe blended potatoes inside (taste good), what about bodybuilder food?

There are these mass builder protein/carbohydrate shakes. Of course she wouldn't like it in the quantities bodybuilder use it. But a glass of normal milk with it, taste like cacao just between instead of drinking water?

A friend of mine ate Astronaut food for a while, it was creme like and contains everything needed. Unfortunately I don't know more about it, maybe someone else does?

Sheryl: I know from professional bicycle racer that they are over night on some intravenous food supply....would that help? I don't want to post something misleading, maybe you know?

Many of the whey protein products contain substances which are supposed to reduce fat, somthing my wife does not need. She needs to retain all the fat she can. However, I have noticed that substances like creatine only burn fat if consumed as part of an exercise regime. Would whey protein substances work in my wife's case? I do not know.

Edited May 5, 2014 by GarryP

[GarryP]

Don't feed her with powdered supplements and similar. Processed food would just make things worse.

Use real food. Get a food blender and blend everything. It sounds gross but it is irrelevant in her case.

Vegetables, fruits, some good fats in the form of olive oil etc, peanut butter, fish and all kinds of meat for protein. Oatmeal, sweet potatoes etc for carbs. Just cook it blend it and tell her to drink it. She will get used to it. And it is more beneficial than any supplements out there. Plus cheaper if that's a concern.

All the best to her and the whole family

Sent from my GT-I9500 using Thaivisa Connect Thailand mobile app

Thanks for the kind wishes.

I really do not have much choice. We have liquidizers and juicers and they have been helpful to a certain degree. She cannot eat salty or peppery foods as she gets a reaction that results in her thoat closing up (she explained it like drowning on dry land). She seems to trust these ready mixed things, like powders, etc. whereas she is worried that if I mix her something up, one of the ingredients might set her off. Personally, I believe part of it is psychosomatic but I do not want to get in a fight over it. Sometimes trying to give support is so frustrating and heatbreaking; it is not always taken as intended and seen as "nagging".

Edited May 5, 2014 by GarryP

[robblok]

One thing that works is this:

Take whey protein, take oats and milk and maybe some cacao. Blend it all together and you will gain body-weight for sure.

Don't worry whey protein wont burn fat i wish it did.

And good luck.. i wish you and her strength.

Edited May 5, 2014 by robblok

[GarryP]

One thing that works is this:

Take whey protein, take oats and milk and maybe some cacao. Blend it all together and you will gain body-weight for sure.

Don't worry whey protein wont burn fat i wish it did.

And good luck.. i wish you and her strength.

As someone who pumps weights (you not me - I have followed you on Thaivisa but not stalked ), I really appreciate your input.

[A1Str8]

Don't feed her with powdered supplements and similar. Processed food would just make things worse.

Use real food. Get a food blender and blend everything. It sounds gross but it is irrelevant in her case.

Vegetables, fruits, some good fats in the form of olive oil etc, peanut butter, fish and all kinds of meat for protein. Oatmeal, sweet potatoes etc for carbs. Just cook it blend it and tell her to drink it. She will get used to it. And it is more beneficial than any supplements out there. Plus cheaper if that's a concern.

All the best to her and the whole family

Sent from my GT-I9500 using Thaivisa Connect Thailand mobile app

Thanks for the kind wishes.

I really do not have much choice. We have liquidizers and juicers and they have been helpful to a certain degree. She cannot eat salty or peppery foods as she gets a reaction that results in her thoat closing up (she explained it like drowning on dry land). She seems to trust these ready mixed things, like powders, etc. whereas she is worried that if I mix her something up, one of the ingredients might set her off. Personally, I believe part of it is psychosomatic but I do not want to get in a fight over it. Sometimes trying to give support is so frustrating and heatbreaking; it is not always taken as intended and seen as "nagging".

Well if you buy the stuff like uncooked meat vegetables potatoes fruit etc and add nothing to it then she has nothing to worry about. It will contain no salt and other things. And sure if she trusts those ready mixed things then fine, eat it but I suppose she has been doing so for a while and she still suffers from malnutrition so it might be wise to try real food.

Sent from my GT-I9500 using Thaivisa Connect Thailand mobile app

[robblok]

One more remark, the idea is not to eat this as only source of food, that would be bad. I am seeing this as an extra to what she is eating already. Doing just the shakes I was talking about as only source could be bad as you don't get much vitamins then.

So I am agreeing with A1Str8 about getting other sources too. As an additive its good, you might want to look into some vitamin tablets too. I am not 100% convinced they work but I still take them just in case.

I also have a vegetable juicer, you can juice vegetables with it and swallow.. though depending on what you combine its not a nice taste but real healthy. But if she is picky as you said.. no chance for that then.

[h90]

Beside beef (or pork) soup with egg and maybe blended potatoes inside (taste good), what about bodybuilder food?

There are these mass builder protein/carbohydrate shakes. Of course she wouldn't like it in the quantities bodybuilder use it. But a glass of normal milk with it, taste like cacao just between instead of drinking water?

A friend of mine ate Astronaut food for a while, it was creme like and contains everything needed. Unfortunately I don't know more about it, maybe someone else does?

Sheryl: I know from professional bicycle racer that they are over night on some intravenous food supply....would that help? I don't want to post something misleading, maybe you know?

Many of the whey protein products contain substances which are supposed to reduce fat, somthing my wife does not need. She needs to retain all the fat she can. However, I have noticed that substances like creatine only burn fat if consumed as part of an exercise regime. Would whey protein substances work in my wife's case? I do not know.

I don't know if it helps, but no worry about substances that reduce fat.....They don't they only SHOULD allow the body to convert fat easier to energy in case you are on diet. But first of all it doesn't work, second it doesn't harm, if it would work it would only make the body more efficient.

But I don't mean these pure protein drinks, I mean what they sell as "weight gainer" have a look at phuket health shop.

I don't know if it helps, but surely it can't harm.

[h90]

Don't feed her with powdered supplements and similar. Processed food would just make things worse.

Use real food. Get a food blender and blend everything. It sounds gross but it is irrelevant in her case.

Vegetables, fruits, some good fats in the form of olive oil etc, peanut butter, fish and all kinds of meat for protein. Oatmeal, sweet potatoes etc for carbs. Just cook it blend it and tell her to drink it. She will get used to it. And it is more beneficial than any supplements out there. Plus cheaper if that's a concern.

All the best to her and the whole family

Sent from my GT-I9500 using Thaivisa Connect Thailand mobile app

Thanks for the kind wishes.

I really do not have much choice. We have liquidizers and juicers and they have been helpful to a certain degree. She cannot eat salty or peppery foods as she gets a reaction that results in her thoat closing up (she explained it like drowning on dry land). She seems to trust these ready mixed things, like powders, etc. whereas she is worried that if I mix her something up, one of the ingredients might set her off. Personally, I believe part of it is psychosomatic but I do not want to get in a fight over it. Sometimes trying to give support is so frustrating and heatbreaking; it is not always taken as intended and seen as "nagging".

A while ago I had that a couple of times, you can't breath. Drowning on dry land is pretty exactly how it feels and you are pretty sure that if it continues you'll die. It is really extreme bad and scary and I wouldn't wonder if someone dies from an heart attack during it.

Something like pepper or chilli can trigger it when you are anyway close to it. Stress is also making it worse.

And believe me, after the second time you got it, everyone gets paranoid......

[Sheryl]

You can certainly make liquid supplements on your own, cheaper and better tasting than any you'd buy.

Adding oil is important since it is calorie dense -- coconut oil often best in terms of taste.

Try blending coconut oil, soy or cows milk (depending on whether she tolerates milk), adding a daily dose of a liquid multivitamin/mineral supplement and then according to what she likes:

- coca powder (if she likes chocolate)

- ice cream of favorite flavor

-fruits like banana, mango

But if she insists on powdered foods, you can get them but basically not much difference than Ensure. Adding a tablespoon or so of coconut oil to ensure will increase its caloric value.

However it sounds like the cancer is progressing and if so, no matter what you do, she is going to waste away, the best you can do is slow down the process a bit. Cancer cells compete with other body cells for the nutrients and all patients with advanced terminal cancer are malnourished and thin, it is unfortunately the way it goes, and nothing can stop it.

If you have not already this would be a good time to think about ensuring she has enough pain relief now and later on, which means also after she is unable to swallow oral medication, which time will come. You need a doctor willing and able to provide appropriate analgesia. When she can no longer swallow pain meds, the choices are: (1) fentanyl skin patches (have to get from a hospital pharmacy and may have to take the initiative to suggest it to the doctor) (2) admission to hospital for IV medication (in which case she will stay there until she dies) or (3) insertion of a tube into her stomach so that medications can be given there bypassing her throat. Such a tube can be inserted right at the abdomen and once in place is not uncomfortable. It can also be used to give liquid food and water although frankly by the time it is needed, giving food isn't going to do more than delay the inevitable and probably by not that much time.

Related to this, may be time to discuss her wishes in terms of dying at home vs. in a hospital. If she wants to die at home, then ensuring that you will be able to get adequate pain meds in a form she can take even when no longer able to swallow is essential. As is lining up a sympathetic doctor supportive of the decision to stay at home; normally Thai doctors just expect people to come into the hospital and die there once they are no longer comfortable at home and the idea of providing treatment to allow a peaceful death at home is not widely understood. In addition to pain meds, will need something to dry up respiratory secretions and also to alleviate anxiety. You'll also need help at home taking care of her, when that time arrives.

And it might be well to have her execute a living will in case she does end up in a hospital. Without one, they may prolong her suffering

Sorry to hit you with all this when you are already upset about her nutritional status but better to be prepared, as from what you describe this is what you will soon have to face.

[GarryP]

One more remark, the idea is not to eat this as only source of food, that would be bad. I am seeing this as an extra to what she is eating already. Doing just the shakes I was talking about as only source could be bad as you don't get much vitamins then.

So I am agreeing with A1Str8 about getting other sources too. As an additive its good, you might want to look into some vitamin tablets too. I am not 100% convinced they work but I still take them just in case.

I also have a vegetable juicer, you can juice vegetables with it and swallow.. though depending on what you combine its not a nice taste but real healthy. But if she is picky as you said.. no chance for that then.

The protein supplements are just that, supplements. She will be taking them in addition to her normal restricted diet.

[GarryP]

My wife is in remission. Her weight loss is purely down to a really poor diet due to problems swallowing and lack of saliva. In any case, thank you all for you input/suggestions. I did not know bout coconut oil so will suggest it to my wife when I get home as she uses coconut oil to rinse her mouth from time to time.

[fletchsmile]

Garry

You might want to check out:

Spirulina - capsules or better still powder that you can just add water to and make a drink. Very high nutritional values for protein, vitamins, minerals etc. Capsules easily available in many places including Boots. Powder more difficult to find

Chlorella (bio chlorella) - for immune system - and complements spirulina - can buy "small pill size" pharmacies like P&F

Wheatgrass powder - internal oxygenation - a lot of the nutrition shops

Chlorophyll - for detox - GNC capsules

All 4 are variations on plants/ algaes, so more natural in nature. Plus have links to benefits against cancer. Although there's always as much literature that claims otherwise as for when it comes to cancer, there is strong evidence for all the other properties I mention.

Other supplements to think about:

Turmeric or curcumin (as in the yellow Indian curries) you can buy bottles of the capsules in many pharmacies. Has alleged anti-inflammatory links as well as cancer. Also some links to easing pain - perhaps linked to the anti-inflammatory properties.

Probiotics to help with healthy bacteria in the gut, to help proper food absorption and maximise absorption of what little is actually being consumed. The gut/intestines is also more and more becoming recognised as a key part of the immune system. Capsules available form pharmacies/ drug stores.

Buy the ones with the most recent manufacture dates, as all have a tendency to deteriorate over time.

Not sure the best way to build mass, but I do believe the above will help in the ways mentioned in reasonably natural easy to absorb forms.

Personally would stay away from refined sugars and high sugar containing products which there is a lot of research and literature linking to cancer. (Then again you can link almost anything to anything these days

Best Wishes

Cheers

Fletch

Edited May 6, 2014 by fletchsmile

[Jingthing]

You could look into making your own Soylent:

http://diy.soylent.me/

http://www.newyorker.com/reporting/2014/05/12/140512fa_fact_widdicombe?currentPage=all

[sirineou]

Sorry to hear about your wife, hope everything works out well.

I don't know if this would be appropriate for your wife,

But back when I used to spend a lot of time in the Gym, and I could not eat enough and of the right things to get the proper caloric intake

I use to make Whey powder protein drinks, and aside from being Delicious they were protein and calorie bombs.

in a blender blend two scoops of Whey protein(vanilla flavor) , milk , and two tablespoons of peanut Butter.

or

Two scoops of protein (vanilla flavor), orange juice , and a banana

Best of luck