Thursday, February 11th 2010

Reduced appetite and dietary supplements

Back at the start of the week in my meeting with Lara one of the things we discussed was my declining appetite and the recent early signs of problems with swallowing. I’ve been struggling to eat meals for some time now but only in the sense that I just didn’t feel hungry and not that I couldn’t actually get the food down. One of the things I’d requested of Lara was a chance to discuss the matter with a dietician. I wanted to find out what sort of calorific intake I should be aiming for now that I lead a more sedentary lifestyle because up till now I’ve essentially been trying to eat the same way I always have when I was fully mobile. But of course when you lead a normal active lifestyle you consume a lot more calories than if you were sitting down all day as I am now. And because the whole process of eating a meal is beginning to tire me out I wanted to look at eating smaller portion sizes more frequently and to top them up with some kind of supplement drink. Lara left me a leaflet on fortifying food and made arrangements for me to speak with a dietician.

On Tuesday morning I had a telephone consultation with a lady called Isabelle who told me that she would gather some information on my diet and then pass my details over to a dietician who would be contacting me at home at some point. For now though she just wanted to build a picture of what my current difficulties were so we ran through the usual sorts of questions such as how often was I eating and what were the portion sizes, what sort of food was I eating, how often did I take fluids, what was my height, and how much did I weigh? I did ask about how many calories I should be aiming for each day but she declined to answer saying that it was more important just to concentrate on eating the right kind of food than eating to a target. When we talked about how tiring I was finding it just getting through a meal the subject of high calorie drinks as a supplement came up and would I like to try them? Well I’ve heard about these Ensure drinks but most of the feedback I get is that they are not particularly nice. Nevertheless if it was a way of supplementing my reduced food intake then it was worth exploring so Isabelle liaised with my GP and arranged to have them added to my prescription. In the meantime Lara had already made arrangements for some samples to be delivered and these turned up that evening.

So for the past couple of days I’ve been wading through these samples, some of which are like a fruit juice whilst others resemble a milkshake. Yesterday mid-morning I tried a strawberry fruit juice which didn’t taste too great and smelt even worse but at least were easy enough for me to swallow. Because they are a highly concentrated drink packed with calories it is not advisable to have one closer than an hour to a meal so I thought about an hour and a half should be safe but I still felt full up when it came time to have my lunch. The same thing happened in the afternoon when I tried the strawberry milkshake version which did taste better than the fruit version although two hours after finishing it I was struggling to eat my dinner. At the moment I’m just experimenting to see which flavours I can tolerate. In the long run the idea will be to have one or two of these a day as a calorie top up. That way I can look at reducing the size of my dinners which in turn should not tire me out as much as they are at the moment. The trick will be getting the balance just right. I don’t want to give up on solid food but realistically the days of me eating large meals is probably over so for the future I expect the best strategy will be to just concentrate on eating a little of everything I like and keeping the portion sizes small.

Today a delivery van turned up with my first prescription of 40 Ensure drinks!

Mark

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