Esophageal Cancer 101
The Facts—just the Facts
In November of 2008, my husband, Michael, underwent a surgical procedure for esophageal cancer—a transhiatal esophagectomy (THE), which in lay terms means “removal of the esophagus.” Before you gasp just thinking about having three-quarters of this useful muscle removed, it should give you some comfort to understand that it’s being replaced by a portion of the stomach. I know you’re wondering how it’s possible for a stomach to replace an esophagus, so let me explain.
The surgeon, or magician, as I like to call them, moves the stomach upward through the hiatus and into the chest until its upper end appears in the neck wound. The remaining esophagus is then connected to the stomach. The surgeon leaves a small portion of the stomach to function in its normal capacity, although I hesitate to use the word “normal” as there isn’t anything normal about this surgery.
It’s all about Nutrition
Fulfilling daily nutritional requirements can be difficult for a healthy person, but after undergoing a THE, it’s becomes a huge challenge. Weight loss is an automatic 20 to 30 pounds after surgery and don’t count on the pounds returning anytime soon. The key to alleviating some of the digestive discomfort is the following:
- Introduce foods into your diet gradually, as milk or chocolate products may not be tolerable.
- Eat smaller meals frequently during the day.
- Pack a power bar, vitamin protein drink, and a bag of trail-mix.
- Eat slowly, chewing each morsel of food. If you overeat, an uncomfortable feeling of fullness will devour your insides and you’ll spend the next hour groaning on the nearest sofa.
- Drink liquids before or after meals—not during.
Last Christmas, a month after Michael’s surgery, we were at our son’s house for a family dinner. I watched him as he ate a thin slice of chocolate cake slathered with a thick layer of fudge frosting. Half-way through his desert, he said, “We need to leave—now.” His facial features grew tense as he said his goodbyes and walked out the front door toward the car. I asked him if I should drive home. He nodded his head, handed me the keys and in a weak voice said, “My stomach feels like it’s on fire.”
When we arrived home, I helped him to the couch and set my parameters. “If you’re not better in twenty minutes, we’re going to the hospital.” I gave him a dose of his prescription pain medication hoping it might alleviate some of his discomfort. Within fifteen minutes he turned to me and said, “The pain is lifting.”
Michael’s discomfort disappeared within the next thirty minutes, as did the word chocolate from our shopping list. The next word to be carefully considered was ‘sugar’ as in cookies, muffins or other sweet treats. This consideration had more to do with timing than anything else. All sweets needed to be consumed after a meal, never as an in-between snack. Michael learned this the hard way when we stopped at a restaurant for a quick pick-me-up, as he calls it—a cup of coffee and a muffin. An hour later while shopping for groceries, my husband displayed the following symptoms:
- Sweating profusely
- Weakening of extremities
I promptly found a chair for him, grabbed an energy drink from our cart, twisted open the cap and handed him the bottle. Within a few minutes, he felt better. This experience was a direct result of a low blood sugar created by the surgical procedure.
Drastic diet changes aren’t ever easy to adjust to—especially in our adult years. Michael and I used to think of dining as a way to relax and socialize while treating ourselves to delicacies and tantalizing meals. It’s difficult to continue that mindset while one’s faced with constant food restrictions and stomach upsets.
We no longer meet our friends for gourmet three-course meals, highlighted with a light and fruity Pinot Noir. We’re now happy to enjoy an appetizer, if it’s not fried, split a main course as long as we agree on the entree, and substitute sherbet for ice cream. We’ve adjusted nicely to our different lifestyle, even if it does mean spending hours cooking in the kitchen, finding new recipes, reading food labels, and learning to enjoy a simpler existence. It’s one of those life changes that seem small in the scheme of things.