Saturday, March 03, 2007

Appetite

Not having had an appetite for much of the last six weeks (chemotherapy), but especially the last three days (stomach virus), I woke up during the night thinking about appetite, and writing a post on the subject. Also, I was talking with Tia last night, and we were commiserating about the lack of appetite, and how hard it is to eat when nothing tastes good.

Where does our appetite come from? Most basically, it's an element essential to human survival, ensuring that we get the food and beverage needed to sustain life. Why does appetite change? Illness, certainly, and as so many of us know, the treatment for cancer known as chemotherapy. With so many of us in the U.S. struggling to keep our weight under control, when faced with a dizzying array of possible, delectable things to eat and drink, it's a bit strange to be thinking about appetite and lack of it. But for those of us with cancer, and those of us undergoing chemotherapy, lack of appetite is very real. It's not just nausea, although that's part of it, it's that even when we eat, things just don't taste that good.

For most of my life, I have loved to eat. I love the smell, texture, taste of food, and I enjoy cooking and baking. My first extended period of detachment from the joy of eating came in 1995 when I contracted dengue fever after a church mission trip to Nicaragua. (At least I assume I had dengue fever, although it was never confirmed by a lab.) Fever, nausea, vomiting, diarrhea, lots of the same symptoms of a stomach virus, but it just didn't quit. I was pretty sick for three weeks, and got better only slowly. As I recovered, I found I was only interested in "white food" - potatoes, pasta, bread, bland food. I would watch others eating, and would remember, distantly, enjoying eating, looking forward to meals. It took a long time for my previous relationship with food to return. My experience with chemotherapy is more like that experience with food and lack of appetite than any other I've had.

In researching this post, I learned that there is a scientific journal called Appetite. The research areas for publication cover a wide range of topics, including "behavioural nutrition and the cultural, sensory, and physiological influences on choices and intakes of foods and drinks. It covers normal and disordered eating and drinking, dietary attitudes and practices and all aspects of the bases of human and animal behaviour toward food." Who knew scientists were interested in all of those things? Clearly, anything I can say on the topic is very limited!

There's also a book about food and eating called Appetite, by Nigel Slater. He reflects on our relationships with food and food preparation, and also seems to include some recipes. I never heard of this book before, but it sounds interesting. However, in the table of contents, there is no mention of "chemotherapy" and appetite. So, that's no help!

So what can those of us on chemotherapy do about our lack of appetite? Doctors can give us anti-nausea meds (and they do), and I guess there are even drugs to stimulate appetite (I heard a doctor prescribing some to the person next to me in the chemo room). But I'd like to stimulate my appetite without drugs, and make sure that I am getting the nutrition I need to support my body's functioning and fight against this cancer that endangers my existence.

One book that specifically focuses on what those with cancer can do about loss of appetite is Return to Wholeness by David Simon. He's an M.D. with an ayurvedic perspective, so he talks about a drink to stimulate appetite (equal parts gingerroot juice, lemon juice, honey, and water with a pinch of black pepper; how do I squeeze juice from gingerroot?), and some natural ayurvedic shakes and soups. I remember reading this section of the book last fall, when my appetite was normal, and thinking I probably wouldn't need his suggestions. Was I ever wrong! Now that I've rediscovered it, I need to try some of his ideas.

I began this post this morning, and now I'm ready to put it on the blog. Over these hours, I've experimented with trying to eat more. I woke up thinking about homemade blueberry muffins, so I made them. They were good, but didn't taste quite right. Then I tried a half-banana, a drinkable yogurt, and some reheated mashed potatoes. (I decided to return to the "white food" approach to diet!) So far, so good. Thanks for reading my ramblings on this topic!

6 comments:

Anonymous said...

Dr. Simon's drink reminds me of a ginger tea concoction that I learned from Jan who learned it from her grandmother. The first time she insisted that I needed some when I was sick with the flu I truly thought she was trying to poison me! She would mix ground ginger with hot water some sugar or honey and milk. It was really hard to get used to, but it did seem to help. Since then I have found ginger tea bags with lemon grass and leave out the milk. It is more palatable and seems to help when I'm ailing. I also sipped it when things just didn't feel right with my stomach during chemo. Maybe you can get ginger root juice at the health food store.

Here's to sunshine and sand and ocean and the peace of the islands! Sondra

Tia said...

Aloha, Lynne,

A refreshing drink I learned about at our wonderful Farmers' Market is homemade ginger ale. It works wonders for a queasy stomach.
Peel (but not too perfectly) fresh ginger root and slice in nickel-thin coins. Simmer for 30-40 minutes, including sweetener of choice. Strain and chill. Then use as a refrigerated concentrate, adding club sode to taste; add a bit of squeezed lime.
I know we can't do this as much of a cold drink while we're on oxaliplatin, but it's still pretty good at room temperature(but much better chilled).
I always learn so much from your posts, Lynne. Mahalo for your research.
Only a few more days until you're under the palm trees and swimming in those warm tropic waters. Makes me all the more grateful for my home.
Love,
Tia

Anonymous said...

Lynne,
It was so nice to see you today at church and to get to chat!
As I told you, I do have another friend who is battling the battle of "nothing tastes good" after losing her sense of taste to a tonsillectomy ( believe it or not!) It's been at least a whole year for her. She not only has no sense of taste..the tastes that she DOES have are horrible she tells me. She too loves to cook and is known for her HUGE feasts and her gourmet baking. (She was a professional chocolatier). I will ask her what she has done to perk her appetite...maybe she has some tips too.
My mom boosted her calorie intake with Ensure and drinks like that...although...I don't know that they are wonderfully satisfying....I hope they are better than the stuff I tasted from someone who was trying to lose weight....slimfast?...it tasted like motor oil! eyuuuh!
ANYway...I can't say I have ever had the problem of not wanting food....however....fresh ginger root and club soda sounds refreshing...and would help any nausea you might encounter!!
If you are leaning toward white foods...potatoes...(yum!) I used to love half a baked potato...nuked with just about anything on top....the cheesier the better!! (hmm...that sounded funny!!)
Perhaps some tropical fruit salads and smoothies in the tropical paradise you all are going to will be just the elixir that you need!!
You must be so tired of it all, Lynne! Don't despair!!! I just know that you will get through this wall and on to better days!
I am envisioning a lot of healing light (sunshine!) around you, my friend.
May the sun,sand and the nectar of the gods, along with the love of your family (lots of hugs and laughter!) bring you a much needed ...and deserved relief from all that you are battling.
Happy trails!!
love
Cori

Judy said...

Lynne,
It was good seeing you in church today and as always you are in my prayers, I will be thinking of you tomorrow.
Glad you will be getting away with the family someplace warm, sounds like a great place to go camping and sit in the sun.
I have another friend going thru with chemo with breast cancer - she doesn't have problems with her appetite but with her it is fresh vegatbles she can't eat including salads.

I like Sondra's ginger tea sounds good to me, another tea lover.

Judy R.

Anonymous said...

Lynne,
The picture of you trying to squeeze juice out of a ginger root gave me a giggle. :-)) Jan's ground ginger thingy sounds vile, but I guess if Sondra was able to gag it down and it helped, it probably isn't as bad as it sounds. ;-) I stick with my hot water, lemon juice and honey. Dr. Simon adds ginger root juice and pepper. Hmmmmm....well....I hope it works!
Dengue fever? A mission trip to Nicaragua? You DO have a broad experience of life, my friend! Take care of you, Lynne,
Love,
Mary M

Carrie said...

Lynne, this is too weird. I was just going to post the same topic. Mom is having an awful time with eating just now. I'm really worried about her because of it, and now for you too. Anyway, I did some research and will post it. Meanwhile, i'm looking forward to any tips you find. Your head is in a much better place than mine or Mom's just now so if you hit on something to help, that's a huge help to us as well.

{{Hugs}} & Love :)