Thank you, David. I'd really love to get back to school, but I need to be able to talk for that. I'm learning to be more patient though. Trying to keep my mind and body sharp in the mean time!

Come South and I'll teach you how to prepare tax returns for a few months.

Well,

I finished tx 11-4-2008, I don't view myself as anorexic; although, it becomes hard to eat and then I became really use to the liquid diet and I find myself forcing myself to eat. Because, eating as usual has dramatically changed from the norm. I have added soups to my diet of VHC and supplements.

I never had the PEG...But I assume others have become dependent on it...That was one of my concerns.

I don't think I would say I am dependent on my PEG (well I am to get my total nutrition), but I find myself using it instead of going to the trouble and the mess of trying to eat. I'm not sure how to deal with this - I keep hoping that the post tx side effects will lessen and eating will be more enjoyable again. Then there is that time factor too - it takes me so long to eat the smallest amounts and if I'm really hungry, the PEG is faster.

Patty

Anorexia is different from anorexia nervosa. I see many people here making that mistake. Anorexia Nervosa is a condition associated with poor body self image and what we typically think of when we hear the term "anorexic."

Technically, anorexia just means a loss of appetite. Do I ever have a case of anorexia!

I started out at 226 pounds (5 ft. 6 female) when I was diagnosed in March 2007. I had a hemiglossectomy followed by chemo and radiation. I had a peg tube placed in June 2007. I don't think, even with the peg in, that I EVER kept any nutrition inside of me - I vomited constantly. My weight plummeted and has continued to decline even 18 months after treatment.

I now weigh 114 pounds on a good day and am nothing but skin and bones. I've lost 50% of my body weight in less than 18 months. A person with anorexia nervosa might not be able to see how thin he/she is - wow - do I ever see how skinny I am and I really hate my appearance. I'm only 38, but starting to look far older than my years because there is no fat in my face.

I struggle every day to have an interest in food. I can smell food and think to myself "that smells good," but my body doesn't want to eat it. I put food in, but any more than about 300 calories at a sitting and I'm so stuffed that I feel ill. Food is uncomfortable in my mouth - so maybe a pain stimulus is part of what keeps me from wanting to eat. There is literally not a single food out there that I ever crave or desire in any way. There are foods that aren't as painful and not as difficult to eat - so I eat those because I must.

My thyroid is starting to fail (TSH levels are climbing), but I'm only considered to be in subclinical hypothyroidism. I'm wondering if my thyroid function is what is compounding my weight issues (even though typically in hypothyroidism one gains weight and doesn't lose it easily, a lack of appetite is a listed symptom).

If I had all of the functioning parts required internally in my mouth to be able to chew, swallow and eat I would be a very very happy person again.

Some of us don't have a choice anymore and we struggle with weight loss because we just don't have the "complete package" in our mouth required to swallow and eat like the majority of other people.

We can only work with what we have now and it can be extremely difficult and frustrating.

Karen

As I remarked elsewhere, I am starting to have some food cravings and I am nowhere near being able to swallow anything. I just hope that when I am able to start eating again, that I will have enough functional taste buds to have food taste good.

I don't think there's much of a problem with PEG dependency because that's just a willpower problem; the real PEG problem, for those who may have a choice, like during radiation, is not knowing about or dealing with things like trismus and swallowing. I would recommend to anyone that they get the PEG, maintain it by flushing with water, and just taping it out of the way as a backup -- Having it doesn't mean one has to use it, but not having it means one has fewer choices.

Even now, I have to constantly remember to do some jaw stretching to keep trismus at bay.

Eating with damaged food-processing equipment is hard work and it may be quite difficult to ingest a sufficient number of calories daily to keep one's weight up and support the healing process. During and post radiation, I kept the swallowing exercised by taking my meds by mouth and also my hydration -- I used the PEG almost primarily for food.

My husbands anorexia was pretty bad and the doctor finally put him on Reglan. Which helped with gastro problems and increased his desire to eat. It took several weeks for improvement and the drug can cause other problems so it is important to monitor it.

He is gaining weight now that we have passed the one year anniversary.

I wish I could be of more help, but the only time I really had any desires to not eat was when I was switching from the feeding tube back to oral eating. That was because I was on a continuous feed with the feeding tube and when I would try to take in the drinks by mouth, I would get super full super fast and feel awful after. It was pretty frustrating. But once I got over those issues I was all about food and am constantly eating (and still losing weight I might add).

It's actually difficult to get about 2,000 calories of nutrition in (without eating a lot of the bad fats and other heart-unfriendly foods) on a daily basis.

I believe I read recently that it takes cutting out about 500 cal/day to lose weight at a rate of about two pounds per week -- I presume the opposite is true, so if a typical diet is 2,000 cal/day, one needs to increase that by 25% to gain two pounds/week.

Ha! Found it in a newsletter from my ins co:

"2. Adjust your eating and exercise habits.

On average, Americans consume 2,000 to 2,500 calories per day. To lose 1 or 2 pounds a week, you'll need to burn 500 to 1,000 calories more than you eat each day. Your doctor or a dietitian can tell you how to do this. It typically involves lowering your calorie intake and increasing your physical activity. The goal is to make lifestyle changes that can work for you the rest of your life."