Food Help for 78-year-old w/ Cancer, on Chemo--can't eat anything : (

[Librarian]

so, i need some ideas here, Smart People!

this is for the mother of a dear friend, and he is just about at the end of his rope. he's gone to take care of her in her home out in the rural coal-patch lands of North Central PA, so they don't even have 'net access out there, much less anything to work with beyond your chain-store pharmacies, groceries and Wal-Marts, in terms of supplies.

this means that we need to work mainly/first with what should be available in any "normal" rural grocery/pharmacy store...or maybe farmers market.

i can also order things online to have them sent, but we need some ideas for NOW. my friend is a good cook, and he'll try anything at this point. we're planning a run to the city down here for the Whole Foods and the local Co-Op Grocery for the better food supplies soon, so i'll take those ideas too, please!

current issue: Mom can't eat. she tries, but has no appetite and can't keep anything much down for long. she can handle water, a little fresh pear, and not much else. her very allopathic old-school docs seem unconcerned by this. jerks. her prognosis isn't great anyway i realize, but we're aiming to give her more quality of life, and for that, she *has* to be able to eat something, dammit.

background: last December Mom was diagnosed with lung cancer, but it seemed an early catch, seemed small and very localized. she did the radiation (sorry i don't know what kind, but can find out.) tumor cleared up and she felt a lot better. they kept watching & testing, and then a month or so ago it was back, and all over the place--in her neck, in her back...you get the picture, and it isn't good.

she's in the middle of a first round of chemo now (again, don't know specifics, but can find out) and so far, it seems to harm more than help. it is skrinking some of the tumors which helps with the pain and the breathing, but first she came down with a yeast infection in her mouth/stomach, and then of course the chemo also wrecked her sense of smell and taste and made her nauseous anyway, and now here we are.

she's barely eaten anything since my friend got home to her, and that was almost two weeks ago now. she wasn't fat to begin with, so she's got to be wasting away at this point, and it is killing him to watch and be helpless.

Mom was doing a really good job of hiding her true condition until her son got there.

he's tried normal store stuff like Ensure or Pedialyte, white rice, mashed potatos, milk, jello, juice...even when she can stand to eat a bit of it, she can't keep it down. she's on pain-patches as she can barely manage anything in pill form. she's also on an RX that is supposed to help with this, but so far, not doing much. he's also already tried a little MJ on her, which isn't legal in our state, but even that didn't make her hungry.

now i'm seeing TWO issues here--one is the yeast thing, and the nausea, and while i know what i'd tell a younger, healthier person to eat or try along with her RX, this is stuff she'll never manage to keep down right now, not until she gets turned around a little bit.

the other, more urgent issue, is that she's got to get some nutrients and vitamins and stuff in her soon, or they're just torturing her for no purpose because she won't be able to last through the chemo. he's taken her in twice now for help with this, and they didn't even IV her with fluids for hydration, saying she didn't need it? and yeah, i'm also not feeling that confident in her doctors up there, either.

i have no experience with this type of patient and condition, and i'm a damn librarian not a doctor of any kind anyway, but i'm hoping someone here might have some good advice?

i won't be online here much longer tonight, but i will check back tomorrow night after work, or from work in the afternoon. just fyi.

any ideas are appreciated! she's a cool lady, and she deserves better care!

[esther]

Absolutely no medical experience but real life experience with a daughter and a dog who get car sick. 

Make a chicken broth with carrots, parsley, celery, organic chicken/turkey, tons of garlic and MOST important,  peeled, thinly sliced *fresh* ginger (try @ a quarter of a cup). If she doesn't mind the taste of ginger, try grating it into the broth.   Let it boil for hours so all the goodness of the vegetables and protein from the chicken go into the broth. So even if she just takes sips of broth she might get some nutrition and the ginger might help it stay down.

FWIW

[Broil]

Yes, ginger can help things stay down. 

I think usually vanilla ice cream is used for nauseous cancer people, especially high-fat expensive natural brands like Haagen Dazs. Their simplest vanilla ice cream has only Cream, Skim Milk, Sugar, Egg Yolks, Natural Vanilla, according to their site.     
 

[speaksoftly]

Have you tried peanut butter? For folks without a peanut allergy it can be easy to digest and packs a lot of nutritional punch. It can be added to smoothies or just licked off the fingers.

[Aussie]

I nursed my Mum through bone cancer and my Dad through lung cancer. I can truly relate to what you are going through. It seems that when a body gets to a certain stage it just doesn't want to take any more nourishment. My Mum was terribly wick with the chemo. She just couldn't eat and keep anything in. For her the best thing was a few crackers with a little cheese on it. No butter or fats. Nothing with a strong smell either. Definately no meats, onions, garlic or anything too aromatic. Just a strong smell would send her into fits of vomiting. Not pretty.

A few days after the chemo she would be able to handle things like broths. I made her chicken or vegetable broth. She's also sometimes enjoy some green vegetables. Meat was too difficult to hold down and digest.

My dad went downhill fast with his lung cancer. He stopped eating altogether. He didn't have chemo because his cancer was too advanced and his heart was too weak. The doctors decided to just withdraw his heart medication and let him die peacefully. Well it wasn't at all peaceful. I made broths for dad, but he could only have a little at a time. He went from a healthy 76kg to under 46kg. He had a great deal of trouble swallowing. Eventually most of his bodily functions stopped. He died a while after that.

I think other than trying some ultra bland foods in case it's the smell putting her off, and trying some broth for nourishment there's probably not too much you can do to tempt her to eat. Try real hard to keep up with the fluids. I will keep you and your friend and his mother in my prayers.

[wordnerd]

When my mother had cancer the Dr. put her on a drug that made her hungry and helped her eat

[Jonathan_Byron]

Consider massage with edible oils (coconut, almond, etc) - some of it will be absorbed through the skin provide some calories.

[Dot]

I would see about getting her high. Surely he could get a medical RX for some marijuana? When she has the munchies you can then do the broth, soup, full fat ice cream stuff.

[tofu2u2]

Oh, I know what you're going through (I helped take care of my uncle, he had liver cancer, it went all through his body before he died in 2004; helped a good friend whose small cell lung cancer went to his liver and then all through his body before he died in 2006; helped my cousin with luekemia, she died last week; I helped my cousin who died last week to take care of my uncle (her father), I was the primary caretaker for my friend in '06 and then for my cousin, Eileen, who died last week after 5 cycles of chemo in the past year).

Try bland food, yeah, that helps but the most important thing (and the most difficult) is to STOP focusing on food right now. Eillen & I foccused on food with her father and I obsessed about it about my friend. While Eileen had her cancer, she said she knew how her father must have felt like: she only wanted food when she felt like she could keep it down. She would force herself to eat a little even when she wasn't hungry in order to keep her strength up but naseau rules when you have cancer (with or without chemo). Since she went through 5 cycles of chemo, we were very familiar with the whole spectrum of naseau by the end of her 11 months of cancer treatment.

The real issue for caretakers is that we have  (1) a need to be reassured they are going to get better; (2) we have a need to be "doing something! anything! to help the cancer patient"; (3)  we cant control the meds or the machines or much else but dammit, I can make the perfect [fill in the blank] that they will love, devour and keep in their stomach and then they will get better.

(1) just becasue they eat a lot doesn't mean they will get better or live through it; Eileen had some naseau, lost over 20 pounds on her first round of chemo but after that, she would mostly get diarhea, lost her appitite. In fact, she was losing her appetite the week before she died but would still eat to keep going. My friend that I obsessed about food during his chemo & radiation finally told me that he dreaded seeing those of us who wouldn't leave him alone about eating as much as he dreaded the radiologist. When I finally got it through my head that if he could only eat or hold down a bite or two and that was enough for him and we relaxed about it, then his "meals" were much better for him.

(2) really, the best thing to do now is talk as much as they want to, not to focus on all the busy work that we feel we must do to take care of them. The busy work is a way of discharging our anxiety (and yes, there is a lot of just plain shear physical labor involved in taking care of cancer patients, Im not saying to blow off all the laundry, the hygeine activities, etc etc) but food issues seem to be where everyone goes off the deep end (Eileen & I did with her father: she told me several times that now she knows what we "put him through" while we tried to help him) and there is a lot of acting out about food rather than talking with them about whatever is on their mind at the time.

(3) this goes hand in hand with #2 but as they are more in the control of the medical system, this issue becomes more acute for the caretakers and we act out more.

The bottom line is they will eat what they can (Eileen had a thing for mango and ice cream during chemo; she never liked mango at all before she went through chemo and a breast cancer survivor we know couldnt even look at any red food, either naturally red or dyed red, while she was in treatment but she could eat anything else) when they can. Your friend just has to get used to a 2 bite meal (or a 1 bite meal) and buying and tossing out, then buying fresh & tossing out the unused food, over & over again, because the patient can only eat a few bites.

And don't cook anything like broth in the house, have someone else make it at their place cuz even the smell of boiling water made my uncle throw up although his last meal that he held down was a very rich chocolate cake that I made (he loved that recipe) so we were happy that his last 4 bite (oh we were dancing in the street: 4 entire bites! that means he's gonna get better!!) meal was one he enjoyed so much.


Trust me, Im not speaking out of depression here. It took a long time for me to be able to "get it" that Eileen could regulate what she ate, I was the one who had to adjust my attitude. And Im glad I did, for both our sakes, cuz the real componant of love in cancer care is being there for them, slowing life to their pace so they can enjoy the time they have, talk, talk talk and even when you don't talk, just enjoy their company. Even if they look ravaged, smell bad, tire easily, need help with hygeine & dressing, let them know you love them even in their present condition. Thats what they really need. Eileen felt really bad that she couldn't slow down enough with her father to give him what she learned, through her cancer, that was what he really needed all along.

Good luck with helping this lady and realize, sometimes the best thing we can do is to help them die with love and at their own pace. Frankly, thats how it sounds about this lady if the cancer is spreading like that. I would highly recommend getting in touch with HOSPICE, those people are so helpful, even when you're not ready to "give up" yet, talk with Hospice, they have been down this road so many times.

[kats]

Aussie is right. The body just shuts down at this point. I think it is cruel to keep her on chemo. She is obviously dying. Get in touch with the local hospice and let them take over her care. Without the chemo she might eat a little, but very likely not. Either way, without the chemo she'll be in a lot less discomfort. Hospice will keep her fairly pain free and hydrated and she will be a lot happier. End of life care in this country really sucks, but hospice is the best there is at it and very, very good.

[Dasha]

I have nothing to offer for this particular situation except my sympathies.

This is a good book to have around when you need to provide care for someone:

http://www.amazon.com/Laurels-Kitchen-Caring-Everyday-Caregiving/dp/0898159512/ref=sr_1_1?ie=UTF8&s=books&qid=1256017606&sr=8-1

[Cycling in Hollywood]

Medical marijuana is the perfect cure for this, no I'm not kidding. Chemotherapy patients are one of the major groups that are critically helped by medical pot,  it helps restore appetite and an overall sense of well-being during a brutal treatment process. It is fairly common to see cancer patients at the medical dispensaries here in Cali.

Here are a bunch of links for more reading:

http://www.showmethefacts.org/medical-marijuana-facts/chemotherapy/

If she doesn't want to smoke or never has tried it, edibles would be recommended probably.

so, i need some ideas here, Smart People!
the other, more urgent issue, is that she's got to get some nutrients and vitamins and stuff in her soon, or they're just torturing her for no purpose because she won't be able to last through the chemo. he's taken her in twice now for help with this, and they didn't even IV her with fluids for hydration, saying she didn't need it? and yeah, i'm also not feeling that confident in her doctors up there, either.

[maurice]

A feeding incision can be made that can provide needed nutrition
without relying on eating. Ask the doctor.

[tobyjones]

 ...her prognosis isn't great anyway i realize, but we're aiming to give her more quality of life, and for that, she *has* to be able to eat something, dammit.

the other, more urgent issue, is that she's got to get some nutrients and vitamins and stuff in her soon, or they're just torturing her for no purpose because she won't be able to last through the chemo. he's taken her in twice now for help with this, and they didn't even IV her with fluids for hydration, saying she didn't need it? and yeah, I'm also not feeling that confident in her doctors up there, either.

any ideas are appreciated! she's a cool lady, and she deserves better care!

If he wants to press the issue he can ask to have her a PICC (peripherally inserted central catheter) put in (if she doesn't already have a central line) and have her started on TPN and lipids (IV nutrition).   Most doctors will give in to demanding family almost no matter what they think is best for the patient.  If you want to document that she is not eating and or staying hydrated you can do daily weights.  Are we talking quality of life or quantity of life.  What are the expectations from chemo?  Is her prognosis not good like 40/60 or like 90/10. (chemo fails/remission)  Hospice is almost always worth looking into.  Hospice does not mean stopping all treatment.  Palliative care is still provided.  If you don't feel like she is getting adequate treatment you should always consider a major medical center in Pittsburgh or Cleveland.  

Acceptance is key.  

I don't mean to be offensive but you don't know meaning of "torturing her for no purpose" till the fleas in the ICU get ahold of someone who is terminal but the family refuses to let go.

Flea: another name for an ICU doc aka intensivist.

[kats]

I don't mean to be offensive but you don't know meaning of "torturing her for no purpose" till the fleas in the ICU get ahold of someone who is terminal but refuse to let go.

Flea: another name for an ICU doc aka intensivist.

Yup. And the reason is the US insurance system. They get paid for every procedure they do. A friend was fatally injured in a car crash. They took out his spleen. 3 days later they took out some other organ, etc. etc. My medical friend pointed out that they would go on operating until he died or the insurance ran out because they got paid for each thing they did.  It is cruel and unusual punishment and IMO the family's duty to try and prevent it.