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#122074 09-21-2010 09:28 PM
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vaibhav Offline OP
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My Father just had surgery (1st sept 2010 Partial Maxillectomy + Palatectomy). He has been prescribed Chemotherapy after stitches heal. We need to get his weight up so that he can withstand chemo.
My question is How much Ensure should be used to bring him up to the 3000 cal Diet? One more thing to add is he prefers ensure in milk and not in water.
Another question is, does a person require 3000 Cal or 3000 Kcal?


CG to father, SCC, soft palate - Aug09, 3 TIP, 6 Erbitux + 30 IMRT (60GY) - Jan 10
October '10, Left Partial Maxillectomy + Palatectomy + Recons, 8 methotrexate.Extreme pain in throat and head
August '12 - Right partial Maxillectomy, Left complete maxillectomy, Mandibulectomy, further treatment?
vaibhav #122078 09-22-2010 02:03 AM
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Does your father have the benefit of seeing a dietitian? Many of us have found Carnation VHC to help make it easier to get the necessary calories in. It has 560 calories per 8 oz can. Does your father have a feeding tube? If so, the formula is a little thick, I thin mine down with a can of water. The doc is probably telling you 3000 calories (not sure what Kcals are), even more is ok. High calorie milk shakes can help get alot of calories in also. If your father has a feeding tube, what formula does the doc recommend? Here in the US, a feeding tube will come with prescription formula to order thru a medical supply company.

Best of luck with your fathers continued improvements.


Christine
SCC 6/15/07 L chk & by L molar both Stag I, age44
2x cispltn-35 IMRT end 9/27/07
-65 lbs in 2 mo, no caregvr
Clear PET 1/08
4/4/08 recur L chk Stag I
surg 4/16/08 clr marg
215 HBO dives
3/09 teeth out, trismus
7/2/09 recur, Stg IV
8/24/09 trach, ND, mandiblctmy
3wks medicly inducd coma
2 mo xtended hospital stay, ICU & burn unit
PICC line IV antibx 8 mo
10/4/10, 2/14/11 reconst surg
OC 3x in 3 years
very happy to be alive smile
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My husband takes 6 cans Ensure Plus per day half through PEG tube and half through feeding pump during sleep. His weight has remained steady. Ensure Plus in U.S. has 360 calories per can (if that helps).


CG to sp age 53
4/10 BOT IVb
6/10 Ttl Gloss Lrngectmy L Mndbltmy 5+ Nodes
7/10 Cispl & Rad
1/11 recur lung mets
2/11 Clin Tr Erb Carb 5FU last 5/11
7/11 Tumor growth began wkly Bleo, Taxol, Carbo
10/28/11 Hospice; Passed 11/7/11
Gerri #122133 09-22-2010 11:30 PM
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vaibhav Offline OP
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I am from india. From what i have read from forums, I feel doctors here in India are not have interactive with patients. May be because of the shere Patient/doctor Ratio. He had a Free Flap reconstruction and had a feeding tube through his mouth. First we were told to feed him through the Tube. After 10 Days were were told to start giving him spoon full of water and see if can gulp it down. gradually it was increased to 500 ml. As soon as he was up to 1.5 ltr per day the doctors removed the PEG. We have been told that we can give anything that is crushed enough so that he can gulp down. Currently he is consuming 1.5 ltr of cow milk, about 6 scoops of ensure, rice boiled and mashed in milk. I dont think he is getting enough calories in.


CG to father, SCC, soft palate - Aug09, 3 TIP, 6 Erbitux + 30 IMRT (60GY) - Jan 10
October '10, Left Partial Maxillectomy + Palatectomy + Recons, 8 methotrexate.Extreme pain in throat and head
August '12 - Right partial Maxillectomy, Left complete maxillectomy, Mandibulectomy, further treatment?
vaibhav #122136 09-23-2010 03:42 AM
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I feel for you! I suspect you are right and any additional calories he can take will help. Before Jim has his PEG tube installed I used a high calorie protein powder ordered via internet and added that to his liquified foods to boost calories. He was in similar position early on and his calorie intake wasn't nearly enough.


CG to sp age 53
4/10 BOT IVb
6/10 Ttl Gloss Lrngectmy L Mndbltmy 5+ Nodes
7/10 Cispl & Rad
1/11 recur lung mets
2/11 Clin Tr Erb Carb 5FU last 5/11
7/11 Tumor growth began wkly Bleo, Taxol, Carbo
10/28/11 Hospice; Passed 11/7/11
Gerri #122146 09-23-2010 05:53 AM
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I also use a high protein powder added to my feeding formulas. Protein is very important to the healing process. Here is a link of easy foods. Maybe try some canned peaches, yogurt, puddings, milk shakes to help get more calories daily. Im surprised that the feeding tube was removed before he was more stabilized. Other countries do things differently. A couple times, I tried to eat rice and almost choked to death! If he can eat rice with milk then he should be able to eat other things too like oatmeal and sof scrambled or poached eggs. Best of luck.

http://oralcancersupport.org/forums/ubbthreads.php?ubb=showprofile&User=7386


Christine
SCC 6/15/07 L chk & by L molar both Stag I, age44
2x cispltn-35 IMRT end 9/27/07
-65 lbs in 2 mo, no caregvr
Clear PET 1/08
4/4/08 recur L chk Stag I
surg 4/16/08 clr marg
215 HBO dives
3/09 teeth out, trismus
7/2/09 recur, Stg IV
8/24/09 trach, ND, mandiblctmy
3wks medicly inducd coma
2 mo xtended hospital stay, ICU & burn unit
PICC line IV antibx 8 mo
10/4/10, 2/14/11 reconst surg
OC 3x in 3 years
very happy to be alive smile
vaibhav #122152 09-23-2010 06:10 AM
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Once again it looks like my CCC doctors and medical team have quite different opinions then the standard OCF party line. Their advice has been that I only need 2,000 calories a day to be healthy and active. I just went to the Mayo Clinic's daily calorie calculator and it also said 2,000 calories (Male - 62 - 5'11" 135 lbs -checking Active w/ daily exercise)

That works out to 6 cans a day of Ensure Plus. I lift weights, do Pilates, mow the lawn, etc. For me the issue of energy was thyroid related and not calories. Don't get me wrong, if you can get 3000 calories a day into your dad, GREAT. But for many oral cancer patients, eating is a chore or difficult, and 2,000 calories is just fine.

I had so many things to worry about during these three years, it was great not to try and get 3000 calories down yet still be compliant with medical advice.
Charm


65 yr Old Frack
Stage IV BOT T3N2M0 HPV 16+
2007:72GY IMRT(40) 8 ERBITUX No PEG
2008:CANCER BACK Salvage Surgery
25GY-CyberKnife(5) 3 Carboplatin
Apaghia /G button
2012: CANCER BACK -left tonsilar fossa
40GY-CyberKnife(5) 3 Carboplatin

Passed away 4-29-13
Charm2017 #122176 09-23-2010 03:23 PM
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Posts: 8,311
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Well I have to differ. When I was getting 2000 a day I didn't feel near as active, if you were, as when I consumed 3000 a day. And if adding weight is any indication of calories in vs calories consumed, I didn't gain a pound of weight my entire first year post Tx of consuming 3000 cals a day and I have to feel that if I was only getting 2000 a day during that same period then I surely would have lost weight and therefore I would conclude that 2000 was not enough to offset the "behind the scenes" healing activity that must have been going on. Whew!


David

Age 58 at Dx, HPV16+ SCC, Stage IV BOT+2 nodes, non smoker, casual drinker, exercise nut, Cisplatin x 3 & concurrent IMRT x 35,(70 Gy), no surgery, no Peg, Tx at Moffitt over Aug 06. Jun 07, back to riding my bike 100 miles a wk. Now doing 12 Spin classes and 60 outdoor miles per wk. Nov 13 completed Hilly Century ride for Cancer, 104 miles, 1st Place in my age group. Apr 2014 & 15, Spun for 9 straight hrs to raise $$ for YMCA's Livestrong Program. Certified Spin Instructor Jun 2014.
davidcpa #122191 09-23-2010 09:36 PM
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Posts: 8
vaibhav Offline OP
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Hmm, i too feel that he needs more proteins. The other day he had some rash on skin. I immediately took him to the doctor to check it out. We live on the first floor and he had to climb down and then up the stairs. The next day he was complaining of pain in the thighs region (the kind when you squat too much). I guess all this chemo, radiation, surgery have taken a toll on the body. He is weighing in at 60 Kgs. at 5' 8". But all now he has left is fat.
I have started adding Whey protein powder from On Nutrition in his milk shakes, about 150 gms daily. lets see how things go.
And yes, eating really does become a chore for the patient. He has very limited items to eat from, and more over he has to gulp it down with a cough here and there. No enjoying the Food!!


CG to father, SCC, soft palate - Aug09, 3 TIP, 6 Erbitux + 30 IMRT (60GY) - Jan 10
October '10, Left Partial Maxillectomy + Palatectomy + Recons, 8 methotrexate.Extreme pain in throat and head
August '12 - Right partial Maxillectomy, Left complete maxillectomy, Mandibulectomy, further treatment?
vaibhav #122379 09-27-2010 06:32 PM
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Posts: 158
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Well, I guess I can chime in on this one also. I have been taking in 10 cans of Ensure High Protein for just over a year and a half now. Prior to that I was taking in 10 cans of the regular Ensure. I have been on Ensure, via G-tube, now for in excess of five years. The way I figure it is that I have consumed roughly 15,000 cans over that stretch,.... and I do not own a single share of Abbott stock.

I spread out my consumption in 2 can feedings, 5 times a day. Each feeding is followed by 400 to 500 Ml of water to flush my tube. On occasion I pop a serving into the microwave and put a healthy serving of whipped cream on top. It is amazing how much it makes it taste just like hot chocolate. Oh, yes, probably 99.5 percent of the cans I have consumed have been chocolate. It is one of the very few flavors that I can still taste.

My best to your dad as he travels this seemingly endless road.


No love, no friendship can cross the path of our destiny without leaving some mark on it forever. - Francois Mauriac

Thank you for leaving your mark.
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