Oesophagectomy - diet and hints and tips

Once you have come home from hospital you may find it can take some time to start to eat again. You will most definately not be able to eat the same quantities, or the same types of foods again. Note that this is not forever, your body will adjust to its new stomach over a period of months.

What I wanted to do here is list some tips that have helped me get through this surgery. There are 3 side effects from the surgery on your eating ability which are commenly knowing as 'Dumping Syndrome'. Each side effect also has a list of causes and how to avoid getting the effect in the first place, or how to resolve it once it has started.

1. Tiredness, dizzness and sweating caused by low blood sugar. Your stomach has had its vegas nurves cut. This means it does not know when to release food in to your intestines. As a result your stomach may release too much food too soon. This in turn causes your body to release large amound of insuline to deal with the sugar in your intestine causing in turn your blood sugar level to drop too low.

Causes and Cures

• Eating too much....stick to 6 to 10 small meals a day, at least for the 1st month (I know it's a pain, but do it)
• Eating or drinking high sugar food eg. fizzy drinks/cakes/ice cream. When you feel tired after eating these sorts of foods, have a small spoon full of sugar to bring your blood sugar level back up to normal.
• Drinking after eating. This is a major cause of dumping. The liquid acts like a trigger to the stomach to empty. Have a drink 30 mins before a meal or 1 hour after a meal.

2. Stomach cramps, aches and nausea caused by swallowing too large a piece of food. This causes the small intestine to be stretched causing stomach pains and occasionly the need to be sick.

Causes and Cures

• Eating too large a piece of food or food that cannot be digested easily (bananas). Chew your food throughly. Avoid foods that are hard to break down such as green vegetables. Eat foods that turn to 'mush' easily e.g.
• Jacket potato with cheese,
• pancakes
• mash potatoes
• ice cream
• ice lollies
• soft currys
• crisps
• soft toast
• eggs
• (this is what I currently eat).

3. Slow digestion and constipation caused by your stomach and instine and not performing at peek performance. The symptoms are much the same as in 2 above except the cause is different. There are many more nurve endings in your small intestine, which may be sensitive to food over a prolonged period of time.

Causes and Cures

To resolve this take Maxalon before a meal. This greatly speeds up digestion and pushes the food through to the large intestine which does not have as many nurves.

Oesophagectomy - what's that then?

I needed an Oesophagectomy due to being diagnosed with cancer of the Oesophagus. This required the removal of the whole of my Oesophagus and 1/3rd of my stomach. The remainder of my stomach is then shaped into a new Oesophagus and joined to the back of my throat, allowing food to be eaten.

The surgery is quite extensive and you will be in hospital for between 10 - 12 days. My surgery took place at St Thomas's Hospital under Mr Mason. Mr Mason has done a fantastic job in recreating my Oesophagus.

Getting Through Chemotherapy - ECF

With my cancer, The Guy's and St Thomas's hospital opted for ECF combinations of drugs. The C being Cisplatin, and particularly sickly drug. The side effects can cause nausia in some people. Unfortunately, being young and suffering from motion sickness are key indicators that this drug will make me sick. Please note that this may not be the case for everyone. I know lots of people who have had no side effects, I just happen to be one of the people that did suffer.

Helpful Hints and Tips, please consult your doctor before following any of the tips below.


Tips Before Treatment Begins

1. Eat a small meal the night before treatment starts.
2. Take all your medication including any vitamins etc to the hospital on the day if not before.
3. The treatment can take many hours so take a book or a game to play.

Tips During Treatment

1. When leaving hospital you will be given anti-sickness drugs, take them on time even if you are not feeling sick as it is much easier to prevent sickness than stop it.
2. Don't eat your favourite foods all the time, some people will go off the foods that have during chemotherapy, although I didn't have this problem.
3. The anti-sickness drugs may make you constipated so try and eat some prunes/tinned plums or alternatively take some lactulose or senna in the evening.
4. Take plenty of rest. You will feel tired and want to sleep more than usual. This is to be expected. Rest whenever you need to.
5. If you are suffering from nausea and cannot eat, try some of the supplements your doctor can recommend which are high in calories. Ensure, Enlive. They may not agree with you, but it's certainly worth trying them.
6. Eat smaller meals more frequently.
7. Have plenty of people around you. The sooner you get out and about the better you will feel.
8. Do not do any hard exercise, stick to short walks and shopping.
9. Start a blog and keep a track of your weight, what you eat and your sickness level.
10. Don't give up! You're not alone. Contact the specialist centre dealing with your type of cancer. There are also charities to help such as the Lion's Hospice and the Ellenor Foundation. My specialist group is www.opa.co.uk.
11. Love your partner, they are going through a lot and they may need support. Again, see 13 for assistance advice.
12. Take up a creative hobby. Watch all those films and read those books you have always wanted to.
13. When the nausea wears off, eat as much as you can to put your weight back on.