Diabetic and oesophageal removal - Diet advice

[CollieBoy]

My brother in law is, like me, a T2 diabetic and has just had the top of his stomach/bottom of his oesophagus removed due to precancer/Barratts syndrome :shock: and will be getting out of hospital next week. We just got his diet advice sheet and from a diabetic viewpoint it is a nightmare all pasta/ rice/ baked potatoes and very hi-carb. He is not a lo-carber but has anyone got any experience of dealing with this kind of situation or got any advice.

Thanks,
Fergus.

 

[ebony321]

Hi,

i'm sorry i can't be of much help as i have no experience or knowledge on this and i don't feel comfortabel giving normal advice for people with diabetes when there are other problems there!

but i'm bumping you back up into the new posts section anyway so maybe someone else can help

 

[cugila]

Thanks for 'bumping' it Ebony. Missed this one somehow.

I too am loath to give any advice as it is not a condition I have any experience of and I don't think we actually have any members who have been through it either ? Hopefully somebody might have some experience of it and post their experiences.

All I will say from my own personal experience with recent anti-Cancer treatment is that my Diabetes Consultant just told me that sometimes Diabetes has to take a back seat. What we WISH to do and what we HAVE to do are sometimes at odds. Diabetes isn't the only thing to consider here. A Holistic approach has to be taken.

This needs to be discussed fully with Consultant's, Endocrinologist, Gastroenterologist and Oncologist for the best advice. It may be as with me the diet is only temporrary and then later things can get back to more normal diet. It may also be the case that it is something that will have to be a compromise. That's what I had to do and for months dealt daily with horrendous Bg levels. Now back on track and mostly the levels are all good, some are useless......just something I have had to live with. Discuss with the experts before doing anything that MIGHT not be a good idea.

Ken

 

[phoenix]

I agree this needs specialist advice, as he is still in hospital perhaps he could ask to see a dietitian
I also found the website of The Oesophageal Patients Association
http://www.opa.org.uk/

 

[CollieBoy]

I agree this needs specialist advice, as he is still in hospital perhaps he could ask to see a dietitian
I also found the website of The Oesophageal Patients Association
http://www.opa.org.uk/

Thanks phoenix the advice WAS from a dietician!! perhaps she just didn't read his patient records. Perhaps she will review her advice!!
OPA website now being digested.

 

[hanadr]

An NHS dietician wouldn't find a high carb diet a problem. It's what they recommend to all diabetics.
It's worth contacting DUK and asking if they can help.
Han

 

[cugila]

An NHS dietician wouldn't find a high carb diet a problem. It's what they recommend to all diabetics.
It's worth contacting DUK and asking if they can help.
Han

It's not what 'they' recommend to 'all' Diabetic's Hana. Some of us have had good advice from Dietician's.......one helped me with my diet recently due to drug and radiotherapy treatment. She NEVER recommended a high carb diet and neither does my new Practice Nurse (GP's Diabetic Clinic) My Endo and SDSN also don't recommend any 'high carbs' so I don't think you can generalise. As Ally has stated before she is another who doesn't recommend a high carb diet for all Diabetic's. Each Patient is treated individually.

My experience lately is that they recommend 'reduced carbs', something that myself and I believe IanD and others use to good effect. I do understand that there are 'some' who still do use the plenty of carbs with each meal approach, however the newer ones are a bit more open minded nowadays and are beginning to question this idea. Not quite so cut and dried and not everybody can adopt the low carb/high fat route due to other medical problems. They still control their Diabetes very well.

As for DUK....I am sure they would tell the OP to discuss with the Professional's. The experts. Bit like asking for advice on here we can't tell people exactly what to do, so we offer guidance, sometimes from experience. Dieticians are experienced, and highly qualified and I am sure the one that issued the diet sheet did so with the knowledge of ALL this Patient's medical conditions and didn't just generalise.

The research I did on this particular condition indicates that at least for a while a particular type of diet is needed, for medical reasons. The Patient has had major Gastrointestinal Surgery and therefore a specific diet is needed to aid the recovery. Only later on did they state that the diet could then be adjusted. Most Patients after such an Op, indeed any Op would need time to recover and obviously would need something different from an everyday diet to allow them to build up their strength and let the wounds heal.

Ken

 

[ally5555]

Actually pts who have a partial stomach removal often suffer from dumping syndrome and need to eat slow realease carbs in order to slow down the process. Also avoiding fluids with a meal and keeping meals small and frequent helps.

He needs advice from a gastro dietitian not from here - I cannot give you individual advice but you really should get back to the hospital. Pts suffering from dumping syndrome often get symptoms a bit like a hypo and can suffer from early or late DS.

Hana - stop it I know you have a problem with dietitians - I have seen the rubbish you have written.

 

[ally5555]

oh and ps - ken you are right!

i think the thing many of you do not realise is that in the past we did not have access to individual BS as there were no meters - the first ones 15 years ago cost over £200!and now they are free - it has made a huge difference!

 

[clearviews]

Unbelievable!
The poor guy is diabetic and has had major surgery. He had the good fortune to see a dietitian. The dietitian gave him advice from a reference point, hopefully for a quick recovery from his surgery, with full knowledge of his medical history.
What a pity he/she (the dietitian) could not have stated at the time of the advice that the whole scenario would be reassessed when his recovery was underway to address his diabetic condition. No mental anguish would have needed to be expended.
One can only wonder if the dietitian did focus on the patient as a whole, other than the immediate condition of the patient.
Alison

 

[anniep]

Ally, I wish I had seen a dietican like you, and been treated as an individual.

I was given the standard 'eat lots of starchy carbs' from the NHS dieticain I saw and when I started to talk about reduced/low carbing (Iam never sure where the divding lines are) I was severaly told off and told on no account to do it.

She gave me very basic advice advice about nutrician that I learnt at school years ago, there was nothing geared specifically to my body, or lifestyle etc.

I couldn't even seem to get her to understand my point that as a veggie my protein part of a meal often contains carbs and that to eat pasta and potatoes as well is then is having extra carbs with a meal, because she was so intent on telling me not to low carb.


keep up the good work

 

[ally5555]

that is not good enough is it!

One of the problems is that they are given pt slots and cannot go beyond it so its lierally get them in an out!

Hospital dietitians focus very much on the in pt side which is very different and very technical so out pt services really get a raw deal

I work for 2 GP practices and the pts get me and dont end up seeing loads of different staff who do not know them!

Ally