Once he has the PEG tube, it will be a lt easier. Each 259 ml can of formula counts as 200 ml of fluids. Yu will also have to flush the feeding tube before and after the formula, and that can easily be another 240 or 180 ml of fluids. If he takes six cans of formula a day, he will easily exceed the 2 liters he needs every day. This is the plan John's dietitian has worked out for him. We have been doing this for the last 3 weeks and John has been able to maintain his weight except for the couple of pounds he lost when he suddenly developed thrombosis. The dietitian advises against drinking too much plain water as it will cause an imbalance of the electrolytes in the body.

What are you using to reach the 2500 cals ?

Try reducing the amont of liquids during each consumption, but increase the frequency, sit up while drinking, do not lay down for an hour after, when getting fom a lying position, do it gradually. Sip liquids often through througout the day. Maybe a straw will help prevent big gulps. I had a peg tube, and think that helped too. Oxycodene makes me vomit, so I switched to a Fetynal patch with better results. Actually, the body needs more liquid hydration, which should be about half a persons body weight in liquid ounces, and 20 percent through foods, but understand the difficulty. Caloric intake varies too, and there are different baseline formulas to calculate, some online, and protein needs too, which sometimes can be as high as 1-1.5g protein per pound of body weight depending on caloric need, activity, infection, surgery, active cancer, nutrional status, etc which can increse the body's requirements. Too little protein delays healing, inability to fight infection, and too much can put stress on the kidneys, and actually cause dehydration. Here is one calculatore from the USDA for healthcare professionsals for an estimation.

http://fnic.nal.usda.gov/fnic/interactiveDRI/index.php

I hope you husband feels better, and happy holidays.

Reg is on Nutren 2.0 by Nestle. It's very dense. 500 calories per 250 ml. 16% protien/ 39% carbs/ 45%fat. I'm just wandering if some of the nutrition should be counted as hydration. I may be overy hydrating him if it is.

Bette

Once again I am going to give my standard contrarian advice but only because I think you are being needlessly frightened and worried by a common myth..
I know all the doctors, the OCF posters, even the OCF website and the linked articles repeat the tired old never proven myth that you need 8 glasses of water a day. What I found amazing was that when I asked my doctors and even when I looked for citations on the OCF web site, all I got was : well that's the general advice. How about a study? How about clinical trials or proof? How about any type of medical evidence whatsoever?. Nope, none they sheepishly admitted. Plenty of articles repeating the canard, but none with proof.

I used to link to the 2005 Snopes article 8 glasses water myth I prefer to use the 2011 clever Mother Jones article instead on the 8 glasses myth: Return of the 8 glasses myth

For lots more, just google : 8 cups of water myth or use the handy dandy link below
Let me google that for you

There is lots to worry about but the water myth is not one of them. check his urine, that's what counts.
Charm

The canned drink can be counted, but to what extent I dont know, and may not be totally equivalent. I know liquid intake in general should be 80 percent liquids by mouth, and 20 percent liquid through food in a perfect world, and someting is better than nothing, but doubt you are over hydrating him, if consuming 48 ounces is difficult, vomiting, and just using protein drinks. My intake should be 16 cups daily, which equals 128 ounces, according to this calculator. I usually went by half my body weight, 180 lbs (90 ounces) plus factor in food by 20 percent, which is almost the same. My glucerna 1.5 cal is 8 ounces, so x that by 6 daily is only 48 ounces, so 80 ounces is still needed to be consumed, but needs are different due to activity, health status. The 500 calories x 6 is in the range, which needs generally vary from 2500 -3000 or even higher. Maybe see the nutritionist at the hospital, who can advise best.

I can't do the math but I did ask the dietitian and she said the supplement counts as fluid. An RN at the hospital said 250 ml (1 cup) is counted as 200 ml. Being the exacting type, I have also checked with the RO and he said 6 cans of Nutren 1.5 is enough for John who is about 195 lbs in terms of both calories and hydration. If your husband's urine is a dark color, then he might be dehydrated, if it is normal-looking, then he isn't. That is what the RO said to use to check for dehydration. Hope this helps.

One more thing, practically all the nurses, doctors and the dietitian have told me that the fluid intake should be between 2000 to 3000 ml a day.

Also another quick hydration check method is to pinch and pull the skin up on the back of his hand and then let it go. If it flattens back out then he's OK but if it kinda stays upright then he's dehydrated.

Okay all great advice. His urine output is good and the color is light. I checked the skin and that's okay too. So you are probably right I am worried for nothing. Thanks again everyone. Merry Christmas

Several years before I got cancer, I became very ill. I had been sick for a few days and was getting worse so my friend insisted he take me to the ER. My fever was 105 and I could barely walk. After days of testing the docs finally found out what caused me to be so ill. I was severely dehydrated due to not drinking enough water. I had a bladder infection which went unnoticed and it turned into a kidney infection which was trying to shut down my kidneys. I was told if I hadnt gone to the ER when I did, I probably would have died in my sleep that night. I still remember having several conversations with doctors and nurses about how much water to drink per day. This was years before cancer and I loved to drink my coffee, iced tea and coke. That was about all I ever drank. If nothing else, from this experience I learned that every single person needs water to drink every day even if they are getting fluids from other liquids. I had always thought I got water from the other beverages I drank but I learned that you still need plain old water too. How much? ..... thats another questions that greatly varies.

Even with taking 6 cans of formula every patient still should be drinking a few water bottles a day. This is especially important to flush chemo out of a patients body. Also if a patient has any kidney issues extra water is a necessity while going thru treatments.

Bottom line.... when in doubt check with the doc, the nurses and/or a dietician. By asking each one you can see how different their answers are.