Need HELP Dh wasting away

[Devaskyla]

My dh has been out of the hospital almost 4 weeks now, after having been in there for 2 months and sick for even longer. He was 300lbs when he went into the hospital. He weighed himself yesterday and he was 199lbs. He was about 205 when he got out of the hospital. Thankfully, he was overweight, but not over 100lbs overweight. He is 6'8" and he honestly is beginning to look like a holocaust survivor.

He just cannot seem to eat. He was NPO A LOT in the hospital. A disgusting amount, really, and his stomach has shrunk a lot. He has no hunger, no appetite. He quite often feels like he's going to throw up when he eats more than a couple bites. He never remember to eat (I gave him a bowl of nuts to munch on through out the day in the hopes small amounts often would help, but he never remembers them because he's not hungry).

I bought the Ensure with extra calories, but even those are only 350 calories each & just for basic functions like breathing, he needs a bare minimum of 100, & probably closer to 1500 calories a day. It's a good day if he can get down 500 calories a day, so it's no wonder he's still losing. Some of his meds clearly aren't helping & he has an appointment on Wednesday for follow-up, so he can hopefully get off some of them.

It's getting to the point where, much as I hate going out, I'm seriously considering walking up to the Dairy Queen & buying him a small Blizzard every day, since that's almost 700 calories & if he could manage the dairy (it's hit & miss with him) it would at least maybe stop the weight loss.

[lolar2]

Does he have a digestive disorder? Can he get some IV calories if he can't manage to consume enough by mouth?

[luv-my-boys]

im not suprised that he dosent feel hungry, thats actually a part of starvation. You get to a point where literally despite you wasting away you have absolutely no hunger cues or pangs. I have hyperemesis in pg and this is one of the things that has been the biggest challenge to me, getting enough calories despite not being hungry.

You mentioned he is in the hospital. Is there a medical reason why he should not or might not be absorbing the caloric intake from his food by mouth? If its just a matter of slowly getting him back to eating by mouth. I would strongly suggest NOT automatically feeding him highly caloric foods right away. This is actually one of the worst things to do digestively because its very traumatic on the gut. You must slowly increase the caloric intake/amt over time. In the hospital did he meet with a dietician or nutrionalist? If not I would seriously consider having your dr refer him to one to help set up a plan on how to do so safely and healthfully.

Is he able to hold liquid down? I would be worried immediatly about dehydration. Would he consider going in every few days to get IV fluids and a vit supplements while he is working on getting his caloric intake up? Possibly refer him to a infusion clinic or even home health that would have a nurse come to you guys and do it so that he wouldnt have to be admitted into the hospital. That way he isnt dehydrated and he isnt becoming even more vitamin deficient over time which can compound other problems.

If its a matter of his medical condition preventing absorption of calories I would strongly suggest asking about a feeding tube. They can be placed temporarily and will be able to provide him with the noursihment he needs to recover quicker.

[babygirlie]

6 pounds in 4 weeks after a huge medical problem doesn't sound that bad to me. He is also in the healthy range for men according to charts. It could be shocking to you to see him look so differently, but it is healthier for him to be at a normal weight and not obese. Chances are very likely with home cooked food he will go back to gaining weight and even more than when he started. He's still sick and once his meds and everything even out he will go back to his old eating habits and gain.

[Devaskyla]

Originally Posted by lolar2

Does he have a digestive disorder? Can he get some IV calories if he can't manage to consume enough by mouth?

No, he doesn't. He had acute pancreatitis, which became hemorragic pancreatitis & then necrotizing pancreatitis, complicated by mulitple organ failure due to the pressure from the blood in his abdominal cavity, which required 2 surgeries involving removing his gallbladder & most of his pancreas as well as cleaning out all the blood.

IV nutrition is apparently a 24 hour drip, so he'd have to be in the hospital. You can get home IV treatment here, but not if you need to be on it all day. He was on it for about a week in the hospital, but it didn't help him gain anything, just maybe slowed the loss down a bit.

Originally Posted by luv-my-boys

You mentioned he is in the hospital. Is there a medical reason why he should not or might not be absorbing the caloric intake from his food by mouth? If its just a matter of slowly getting him back to eating by mouth. I would strongly suggest NOT automatically feeding him highly caloric foods right away. This is actually one of the worst things to do digestively because its very traumatic on the gut. You must slowly increase the caloric intake/amt over time. In the hospital did he meet with a dietician or nutrionalist? If not I would seriously consider having your dr refer him to one to help set up a plan on how to do so safely and healthfully.

It's just getting him back eating again. He had a lot of gastroscopy procedures in addition to spending about a month of his time there NPO, his gag reflex is very easily triggered now, which combined with the complete lack of interest in food (despite watching`Food Network for hours every day) makes it really hard to get food into him. He even sometimes has trouble forcing down the Ensure drinks due to the texture. And then he'll go days without drinking one because of the bad association.

There was a nutritionist involved in his care, but she didn't really say much of anything. Everyone seemed to think that once he got home, all his problems would resolve and he'd start gaining again. I'm not sure he'd be willing to see anyone at this point, he's terrified of them wanting to put him back in the hospital.

Originally Posted by luv-my-boys

Is he able to hold liquid down? I would be worried immediatly about dehydration. Would he consider going in every few days to get IV fluids and a vit supplements while he is working on getting his caloric intake up? Possibly refer him to a infusion clinic or even home health that would have a nurse come to you guys and do it so that he wouldnt have to be admitted into the hospital. That way he isnt dehydrated and he isnt becoming even more vitamin deficient over time which can compound other problems.

He's not drinking enough, but he is drinking about 1.5-2L a day. He's not showing any signs of being seriously dehydrated & it's mostly because he can't handle large amounts of plain water & he's getting bored of the things I've found to flavour the water.

There doesn't seem to any kind of home IV treatment for things like minerals/vitamins, unfortunately. I know it's not ideal, but he's said he'll try to get down some vitamins if I get him some. I'm mainly worried about his calcium, potassiun, magnesium & zinc. He was regularly getting IV bags of magnesium & potassium in the hospital. They had him on a drug (which he didn't need) that depletes zinc & never tested his & he occasionally was given tums to increase his calcium levels.

Originally Posted by babygirlie

6 pounds in 4 weeks after a huge medical problem doesn't sound that bad to me. He is also in the healthy range for men according to charts. It could be shocking to you to see him look so differently, but it is healthier for him to be at a normal weight and not obese. Chances are very likely with home cooked food he will go back to gaining weight and even more than when he started. He's still sick and once his meds and everything even out he will go back to his old eating habits and gain.

It's the 6lbs after already having lost 100lbs in 2 months that's the problem.

The charts don't actually work for anyone above 6'2" or so. I can assure that I was not exaggerating about him looking like a holocaust survivor & it has nothing to do with him looking "different". I've seen thin people & I've unfortunately seen someone starve to death & I can assure you I know the difference. At 300lbs, he looked a bit heavy, at 199 lbs, he looks skeletal; he can't even sit on anything that isn't heavily padded because he has basically nothing between his sit bones & his skin.

He's been getting home cooked food for weeks, but he simply can't seem to make himself eat enough calories. My toddler is able to eat more than my husband is right now. I doubt he'll go back to his old eating habits for years, if ever, when he's full after 2 or 3 bites most days.

[oiseau]

I had a bunch of problems convincing myself to eat food while I was going through chemo, so I thought I'd share the few tricks I was able to come up with.
I mainly focused on just getting calories in, regardless of what the food was or how healthy or unhealthy it might be. Chocolate pudding was a favorite and it came in small containers (4oz) which I would eat half of at a time (or just a big spoonful at a time).
Besides that, I just tried to have my favorite foods around and if I was craving something in particular, I found a way to get that thing since it sounded appetizing and I knew I'd eat it.
I don't know if that's really particularly helpful at all.
I guess my best strategy would be to try to just get him to be constantly snacking on something small. Even if it's just a little bite of something every 15-30min, it'll still be getting stuff in. I use that strategy to keep hydrated when drinking becomes an issue (take a sip every 5 min or whatever...).
Would he do juices or smoothies for liquid intake instead of plain water? I really like nectar type juices over ice (Knudsen's makes good pear nectar. peach mango is good too).
Hope you find something that works soon! Eating and drinking can be so stressful when you aren't feeling well.

[Cascadian]

Just a thought...although an expensive thought...maybe you can purchase or borrow a Vitamix and puree good nutrition for him, as well as protein powders, vitamins...milkshakes with fruit and veggies... I know that many cancer patients use them as well as people who need to take nutrition and can't/won't eat, but are willing to DRINK it...

(hugs)

[leafwood]

maybe calorie dense foods all the way? i'm thinking coconut (rice made w/ coconut milk, coconut ice cream, cooking w/ coconut butter), avacado, lots of olive oil. totally different situation, but my son was on high cal diet for a bit and it was all about layering the calories (i.e., dipping organic tater tots in smart balance and olive oil).

[journeymom]

Greek Gods honey yogurt is delicious and made with whole milk and cream, etc. It's as fattening as ice cream.

My mom ate it when she was suffering from cancer and needed all the fat and calories she could manage.

Is this the sort of thing that marijuana would help? I understand some people use it to help stimulate their appetite when they're nauseous.


I'm so sorry, it sounds like your dh went through hell. Devaskyla you are a blessing to him.

[rainbowmoon]

when I had pancreatitis it took me 5 months to be able to eat normally again (And mine was nowhere as severe as your DH,). The thing I ate daily from the time I got out of the hospital is oatmeal. That was the one thing I could tolerate. Ice cream was hit or miss but if he can eat it I would say go for it. Mashed potatoes were another good one but otherwise I really had to stick to bland food. Scrambled eggs, bagels, mac & cheese (not too creamy) and fresh fruit salad was ok too. It took me years before I could digest nuts/almonds, beans and some fats normally again and even now if I eat too much I pay.. I don't eat meat sand have been veg for a long time so not sure about that..I also had to add in raw veggies slowly for some reason but I craved salads constantly!

oh and marijuana definitely helped me. I also used phenegran suppositories as needed. (both were lifesavers!)

[wytchywoman]

Yo Baby yogurt is made with whole milk and it comes in pretty small containers, so it might not be too overwhelming to eat. I just had my older DS in to see a nutritionist as he has failed to gain enough weight the past two years and all the GI workups came back negative. Some of the things she suggested were:
-add calories into everything. add butter, oils, whole milk, heavy cream or powdered milk into anything he eats.
-use dips. Bean dip or hummus for chips or veggies, yogurt or whipped cream for granola bars.
-ice cream
-try to eat a calorie dense food before going to bed.
She also recommended giving my son ensure three times a day. I am not working full time right now and simply couldn't afford the ensure ( and my son eats like a trucker, he just needs more calories than he gets with normal meals) so I have been making him calorie beverages that consist of 8 oz whole milk, two TBSP heavy whipping cream and three TBSP strawberry quick. One drink = 340 calories and he is drinking these three times a day in addition to meals and snacks. He is finally gaining weight.

[rainbowmoon]

I wouldn't advise alot of fats (Or gassy foods like beans) all at once for someone recovering from pancreas issues.

Originally Posted by wytchywoman

Yo Baby yogurt is made with whole milk and it comes in pretty small containers, so it might not be too overwhelming to eat. I just had my older DS in to see a nutritionist as he has failed to gain enough weight the past two years and all the GI workups came back negative. Some of the things she suggested were:
-add calories into everything. add butter, oils, whole milk, heavy cream or powdered milk into anything he eats.
-use dips. Bean dip or hummus for chips or veggies, yogurt or whipped cream for granola bars.
-ice cream
-try to eat a calorie dense food before going to bed.
She also recommended giving my son ensure three times a day. I am not working full time right now and simply couldn't afford the ensure ( and my son eats like a trucker, he just needs more calories than he gets with normal meals) so I have been making him calorie beverages that consist of 8 oz whole milk, two TBSP heavy whipping cream and three TBSP strawberry quick. One drink = 340 calories and he is drinking these three times a day in addition to meals and snacks. He is finally gaining weight.

[2xy]

Originally Posted by Devaskyla

The charts don't actually work for anyone above 6'2" or so. I can assure that I was not exaggerating about him looking like a holocaust survivor & it has nothing to do with him looking "different". I've seen thin people & I've unfortunately seen someone starve to death & I can assure you I know the difference. At 300lbs, he looked a bit heavy, at 199 lbs, he looks skeletal.

I just wanted to say that I understand where you're coming from. My DH and his brother are the same height (6'3"), but have drastically different bone structure and muscle mass. DH weighs about 265 right now, and that's on the heavy side for him (his gut is sticking out a bit). But I've seen him as low as 235 and he looks THIN.

His brother is about 200 and looks normal. He's tall and lanky. DH is tall and sturdy.

[lolar2]

I have a friend who has been on and off IV nutrition (TPN) and IV vitamins and minerals for several years, at home. She does it at night (12 hours or less usually) and a home health nurse comes over to help manage it every week or so. So it may not be available in your area or covered by your insurance, I suppose, but non-24-hour, home-administered IV nutrition does exist. This same friend has difficulty eating and drinking due to chronic pancreatitis, among other things, because the pancreatitis makes the actual eating and drinking painful. She takes narcotic meds to dull the pain enough to get oral nutrition. Is your husband's pain being managed well enough to eat without too much pain?

[deditus]

Yeah, I would be worried that he is in pain.
I would definitely try to get some zinc into him, as being deficient in that can lead to poor appetite. I would use medical marijuana if able/willing to. I agree to go easy on fats - especially with the gallbladder removal as that in itself is a hard adjustment. With part of his pancreas being removed, does he need to take enzymes? I would also try some medical foods. Do you have access to a good vitamin store? We have a really good gluten free store here and one of the owners is a wonderful nutritionist.

[Devaskyla]

Originally Posted by oiseau

I mainly focused on just getting calories in, regardless of what the food was or how healthy or unhealthy it might be. Chocolate pudding was a favorite and it came in small containers (4oz) which I would eat half of at a time (or just a big spoonful at a time).
Besides that, I just tried to have my favorite foods around and if I was craving something in particular, I found a way to get that thing since it sounded appetizing and I knew I'd eat it.

He hasn't had any cravings at all even, until last night, when he had one that lasted a few seconds. And he actually felt thirsty today, so hopefully those are a good step in the right direction.

I've been trying to get him to snack, but even with something right next to him, he just forgets & I feel like such a nag always reminding him to eat. So far today, he's eaten a yogurt. Hopefully he can manage to eat a good supper.

Originally Posted by Cascadian

Just a thought...although an expensive thought...maybe you can purchase or borrow a Vitamix and puree good nutrition for him, as well as protein powders, vitamins...milkshakes with fruit and veggies... I know that many cancer patients use them as well as people who need to take nutrition and can't/won't eat, but are willing to DRINK it...

(hugs)

He's willing to try smoothies if I can figure out some way to make them tasty. I had to look up a Vitamix; I do have a blender I can use

Originally Posted by leafwood

maybe calorie dense foods all the way? i'm thinking coconut (rice made w/ coconut milk, coconut ice cream, cooking w/ coconut butter), avacado, lots of olive oil. totally different situation, but my son was on high cal diet for a bit and it was all about layering the calories (i.e., dipping organic tater tots in smart balance and olive oil).

Originally Posted by journeymom

Greek Gods honey yogurt is delicious and made with whole milk and cream, etc. It's as fattening as ice cream.

Is this the sort of thing that marijuana would help? I understand some people use it to help stimulate their appetite when they're nauseous.


I'm so sorry, it sounds like your dh went through hell. Devaskyla you are a blessing to him.

He really did.

Unfortunately that yogurt doesn't appear to be available in Canada. And I have no idea if marijuana would help. If I had the slightest clue where I could get some for him to try it, I would.

Originally Posted by rainbowmoon

when I had pancreatitis it took me 5 months to be able to eat normally again (And mine was nowhere as severe as your DH,). The thing I ate daily from the time I got out of the hospital is oatmeal. That was the one thing I could tolerate. Ice cream was hit or miss but if he can eat it I would say go for it. Mashed potatoes were another good one but otherwise I really had to stick to bland food. Scrambled eggs, bagels, mac & cheese (not too creamy) and fresh fruit salad was ok too. It took me years before I could digest nuts/almonds, beans and some fats normally again and even now if I eat too much I pay.. I don't eat meat sand have been veg for a long time so not sure about that..I also had to add in raw veggies slowly for some reason but I craved salads constantly!

oh and marijuana definitely helped me. I also used phenegran suppositories as needed. (both were lifesavers!)

Thank you for the ideas! I don't *think* he's having trouble digesting stuff, but he has IBS, so I'm not sure there'd be much difference.

Originally Posted by wytchywoman

Yo Baby yogurt is made with whole milk and it comes in pretty small containers, so it might not be too overwhelming to eat. I just had my older DS in to see a nutritionist as he has failed to gain enough weight the past two years and all the GI workups came back negative. Some of the things she suggested were:
-add calories into everything. add butter, oils, whole milk, heavy cream or powdered milk into anything he eats.
-use dips. Bean dip or hummus for chips or veggies, yogurt or whipped cream for granola bars.
-ice cream
-try to eat a calorie dense food before going to bed.
She also recommended giving my son ensure three times a day. I am not working full time right now and simply couldn't afford the ensure ( and my son eats like a trucker, he just needs more calories than he gets with normal meals) so I have been making him calorie beverages that consist of 8 oz whole milk, two TBSP heavy whipping cream and three TBSP strawberry quick. One drink = 340 calories and he is drinking these three times a day in addition to meals and snacks. He is finally gaining weight.

Thanks for the drink idea! I'm thinking of getting some protein/weight gain powder from the health food store to add to smoothies for a bit of extra calories/nutrition.

Originally Posted by lolar2

I have a friend who has been on and off IV nutrition (TPN) and IV vitamins and minerals for several years, at home. She does it at night (12 hours or less usually) and a home health nurse comes over to help manage it every week or so. So it may not be available in your area or covered by your insurance, I suppose, but non-24-hour, home-administered IV nutrition does exist. This same friend has difficulty eating and drinking due to chronic pancreatitis, among other things, because the pancreatitis makes the actual eating and drinking painful. She takes narcotic meds to dull the pain enough to get oral nutrition. Is your husband's pain being managed well enough to eat without too much pain?

He isn't actually in pain, except what you'd expect weeks after major surgery with a wound that isn't quite closed up (they were packing it for quite awhile). Basically it just hurts him to roll over, get to sitting & if he trips over the kids toys or anything like that.

He was almost sent home on IV antibiotics & home IV were very clear that if he needed fluids or TPN, they wouldn't help & he'd have to stay in hospital

Originally Posted by deditus

Yeah, I would be worried that he is in pain.
I would definitely try to get some zinc into him, as being deficient in that can lead to poor appetite. I would use medical marijuana if able/willing to. I agree to go easy on fats - especially with the gallbladder removal as that in itself is a hard adjustment. With part of his pancreas being removed, does he need to take enzymes? I would also try some medical foods. Do you have access to a good vitamin store? We have a really good gluten free store here and one of the owners is a wonderful nutritionist.

Yes, he does take enzymes. Surprisingly the dr didn't give him a prescription when he left the hospital, though. Luckily he still had a repeat from his first hospital stay. Unfortunately, taking them makes him lose his appetite. Which really doesn't work.

There's a couple health food stores in the mall. One seems really good, the other one not so much.

[karen1968]

what a thing for him and your whole family to go through.

I don't have many suggestions food-wise. But I wonder if a kitchen timer would be helpful in reminding him to eat? You could set it for 15 or 30 minutes and have him eat a bite of yogurt or two almonds or whatever each time it goes off? Then you wouldn't feel like a nag. I know this won't work for everyone, but it seems like something inexpensive that might be worth a try.

Good luck to you both. I hope things turn for the better soon.

[azdesertrn]

My first thought is to take some of the tasty smoothie recipes and freeze them in popsicle molds or ice cube trays so he can eat them throughout the day and you don't have to make them each time. Small frequent portions may be key.

If he tolerates fats, put some coconut oil in the smoothies. Pudding can be frozen too. Can you tell I like frozen foods when I don't feel good?

Also, if he is tolerating fats, any kind of soups with cream can have quite a few calories. Cream of chicken, broccoli cheese.....

Soup/broth would be great anyway to get the minerals even if it isn't high fat.

Homemade stuff is generally healthier. Make your own blizzards at home with real milk (raw?) and ice cream.

If you have access to a juicer, juice some fruits and veggies.

I like New Chapter brand vitamins since they can be taken on an empty stomach.

I hope he is feeling better soon.

[journeymom]

Originally Posted by Devaskyla

I have no idea if marijuana would help. If I had the slightest clue where I could get some for him to try it, I would.

Check the MDC Tribes section. There might be a Canadian mom near you who has a mj connection. I think there's also a mj mothers tribe, as well, who could ...give you pointers? I don't know! But I imagine someone here could help you with this, if you're interested.

Dh and I have both never used. Dh suffers from migraine headaches and in spite of for years being a goody-goody boyscout about marijuana -he's had some doozy headaches lately- he said he might try it.

[mama1803]

How about bone broth? I don't think it is high in calories, but it is chock full of nutrients and is very easily digested. It is also very healing for the gut.

I hope your dh feels better soon. It sounds like he has been through quite an ordeal.