Sept 20

Daily Food Log--1 egg, 1 piece toast (130), 1 can V8 (60), 1 can Boost plus (360),  2 pudding cups, 1 biscuit with honey, 1 cup yogurt, 1 banana, 1/2 cup milk. 

Sept 19

Today was a big day.  The nurse came and took out my PICC line.  I am no longer under home nursing care.  This afternoon and evening I had many bouts of diarrhea.  When I weighed myself I am down to 113 lbs.  On TPN  I was 117.  To eat today I had 2 smoothies (380 calories each), 1 pudding cup (60 calories), and 1 cup cooked noodles (220 calories).  Total=1,000 calories.  I'm thinking that my diarrhea could possibly have been caused by the fact that I added peaches to my smoothies.  That's the only change I made.

Sept 16

Food log--450 calorie smoothie, 1 small wedge of cantaloupe, 1 eggs cooked with sauteed onion, bell pepper, tomato, and squash, 6 saline crackers, 1 sugar free jello cup.  I'll look up calorie count later.  I taught a lesson in RS. today but didn't feel so great.  I still feel full but

Sept 14-15

I ate food today--no Boost.
1/2 cup cooked oatmeal with brown sugar and raisins and milk
lunch and dinner=1 medium trout fillet, 1 boiled yam, 1/2 cup creamed asparagus. I ate half for lunch and half for dinner
1 60 calorie pudding cup

(I'll look up the calorie count later)

I forgot to record yesterday's food but I did well calorie wise.  I think I had 1300 calories.

Sept 13

The last two days have not been near what I need to do calorie wise.  I am on my last bag of TPN which I will disconnect at 11:00.  I am to report on my food log next Tuesday.  Last Tuesday I fudged the numbers a bit because I know that I am ready physiologically to be off the TPN.  But I don't know if it would be right to do that this week.  The numbers are so far down.  My dilemma is that my problem is more emotional than physiological.  More accurately, emotional factors are affecting me physiologically and the result is a diminished ability to eat.  After Lauren, Alysa's eating disorder counselor, brought up how important it is to find alternate coping skills when one is emotionally distraught, I have been more aware of trying to not fall into the habit of not eating when I am emotionally upset.  Normally, I get diarrhea when I'm upset and lose the desire to eat.  What I am experiencing now is a return to the full, watery, feeling that gets worse the more I eat.  When I try to eat through it, I get sicker instead of better.  Thus, my dilemma. I am afraid to eat a bunch of food because I don't want to get feeling worse.  I had hoped to work toward resolving the situation that triggered this but that doesn't seem to be a viable option right now.  Probably the best thing to do when the dietitian calls is to just be honest with her.  Part of me doesn't want to be honest because I know she'll be unhappy with me and I'm afraid that she'll say I have to go back on the TPN.  That makes me feel guilty because it's expensive for Kaiser (no out of pocket for me) and seems completely unnecessary.  But if I am honest about expressing all of these feelings maybe she will let me continue off the TPN. . . . This is why I keep this journal. . . . writing these things down helps me to see what I should do. .. ..This whole topic is actually a subset of the bigger topic concerning what I can do to extend the life of my intestinal tract.   I've learned several things.  First, it is much harder for my body to recuperate from intestinal surgery than most.  Second, my surgeon has made it pretty clear that people have more difficulty with each additional surgery.  Third, as I get older my ability to fight back is not as strong. I have read and will continue to read and learn what I can about how to eat foods that are healthy and easy on my digestive tract, even though every Dr. I talk to tells me it doesn't really make a difference.  Fourth, and most important for me to know, stress has brought on all three blockages.  I have come to believe that, while adhesions are the cause of blockages, stress is the trigger that causes them to constrict and cut off my intestines.  I think that if I can learn to be fully at peace and inwardly calm I can to more to reduce the need for future operations than I can doing anything else. I tend to internalize stress, particularly the kind of stress that comes as a result of friction (both overt and underlying) in close relationships. All three times my intestines closed off I was experiencing that kind of stress.  The first time I didn't make the connection because the stress had been over a long duration.  But the last two times the correlation was pretty obvious.  I have realized that I need to be proactive in improving my relationship with those I live with and working on eliminating behaviors that trigger the kind of emotional response that is destructive.  The logical relationship to start with is with my spouse so we have decided to seek counsel from a trusted friend and counselor.   I don't have any idea what he will tell us but I know that it is both humbling and helpful to have someone to report to.  The return and report doctrine is a true doctrine.   Anyway . . . . I need to get to work but this has been very helpful.   I started this blog as a way to take a step back and see my progress in realistic terms.  It helps me to see what I need to do differently or what I need to continue doing.

Total calories=750-800 (2 boosts, 1 baked potato, 1/3 cup creamed asperagras)

Sept 12

550 calories

Sept 11

Today is the first day of my trial week.  Tomorrow I will use my last bag of TPN.  If I can eat enough they will discontinue the TPN and remove the PICC line.  I have had a lot of anxiety today which complicates eating.  I drank 1-1/2 boosts 400 calories, a smoothie 250 calories, 1 egg (90 calories).  That = 740.  That means I'm about half way and it's almost 7:00 pm.  I don't know how I can make that up.  I was planning on having a bowl of veggie soup with 1 T olive oil for dinner that's 250 calories.  I don't think I can handle anything else.  I'd rather not eat that actually.  I will update this tomorrow. I ate most of the bowl of soup about 200 calories.

Sept 6

I am bound and determined to get off the TPN.  I don't think I need it anymore.  But my doctor told the nutritionist that I have to be at 1500 calories first. The dietitian gave me some ideas on how to up the calories of food I am already eating (adding 1 T. olive oil to smoothie and soup).  Here's my food log for today:
Smoothie (350), Crackers (30), Soup (260), 2 boosts (500), Soup (260)=1440 total calories.  I admit, I feel like one does when they've eaten themselves into oblivion.  I have a stomach ache and don't look forward to eating like this tomorrow. . . .but I will.  I have to.  I'm going out of town for the weekend.  It's going to be hard to eat enough.  I'll have to get some boost because the 2 boosts a day help a lot.  Maybe we can go out to eat and I can get some fish.  Anyway, it will be a challenge. 

Aug 28-Sept 4

I've been terrible about keeping track of my progress this past week. Last Wednesday I talked to the TPN dietitian and she told me that they wanted me to be on it 3 days (Monday, Wednesday, and Friday) for the week. I felt bad that the doctor hadn't told them that we decided to taper me off it soon enough to have the order changed for the week. They deliver 7 bags Wednesday instead of 3 bags. The dietitian told me to throw away 4 bags. That's kind of hard to do, considering each bag costs $1,000. The dietitian told me I should worry about that--that my health was more important and that it was better to throw away the bags than use them if I could get along without them. She asked me to keep track of my weight and how much I ate each day. I told her no problem because I kept a log anyway. Well.. . .. for some odd reason, as soon as I had to keep track I stopped doing it. Now it's Wednesday and I have to try to reconstruct what I ate all week.. . . (I remember Alysa and I trying to do this on the way to her eating disorder clinic and it's pretty hard to do). . . I need to email the list to her this morning. . . .This is as good as I can do. Aug 29--no record. Aug 30--Shapeway smoothie (250), Quaker instant oatmeal (130), baked potato (150), 1/2 cup trader joe's yogurt(60), 3/4 cup cooked carrots (30), 2 boosts (500)= total 1120 calories . Aug 31--Shapeway smoothie (250), 1-3/4 cup frozen "yummy yogurt" (150), boost (250) I think I skipped dinner because I was still full from lunch= total 650 calories. Sept 1--1 cup oatmeal (180),1/2 cup skim lactaid milk (40), 1/2 cup yogurt (60), banana (105), 3/4 cup tomato bisque soup (150)=585 calories. Sept 2--no breakfast (fasting),Shapeway smoothie (250), tortilla with guacamole (100), chicken broth soup with pasta (168), 8 saltine crackers (80)=total 600 calories. Sept 3--3/4 cup oatmeal with milk (220), .8 lbs. frozen yogurtland yogurt (400), 1 cup kifer with fresh strawberries (235)=855 total calories . Sept 4--1 egg yolk (50), Shapeway smootie (250), 1-1/2 cup vegetable soup (150 approx), 6 crackers (60), 2 cup vegetable soup (200), 6 crakers (60)= total 770 calories. My weight fluctuated between 112-119.