A post-op diet to die from?

[treader]

In Bangkok, my Indian' friend has had a hard time of things the last 2 years. I believe he swallowed some glass which perforated the esophagus. He had 2 bad operations, then a 3rd one on Tuesday I think might just be OK.
Several things are worrisome, however particularly his post-op diet. Sony's doctor' suggestions for what to eat post-op seem like utter madness to me. I think his primary concern is to protect whatever he used to close the hole in the esophagus. But how can you heal when given a regime like this. Since the operation until tomorrow he is to have nothing but water. Then, beginning tomorrow he is allowed rice soup without the rice - i.e. rice water. The doctor said something like, "You can eat anything you want, but if it tears open again, the wound will be larger, and the bleeding more." Beyond the rice water stage, I don't know what his instructions are. I suggested I could make a little veggie broth (based on an old formula to bring up alkalinity) consisting of green beans, parsley, zucchini and celery. But Sony said when he mentioned it to the doctor, the doctor said no because of the farm chemicals in the veggies.Even though we're in Bangkok, organic veggies are available here. He's also not supposed to have any salt or oil, milk products, yogurt or sugar. I also wondered about a nice green drink. In the bottom of the same hospital I noticed they had a fresh juice bar, and a bunch of wheatgrass growing there. It seems like he could drink something like that, but the doctor said, "No juices." (Most juices here are pasteurized and sugared.)

Sony's hungry - isn't that surprising? Not only has he not eaten since the operation, but he really hasn't had much food for many months. He'd eat 2 bites, get a lot of pain, and feel full for 2 days. Poor guy! Anyhow, I'm trying to figure out how to get some nutrition in him without it destroying the bands, or whatever it was the doc closed the wound with. It seems the stomach is not of that much concern, if the food gets past the device they installed in his esophagus without dissolving it, moving it, or gumming it up, then things should be OK from below that point through the rest of the GI tract. The doctor described what he used as some kind of bands, and I don't know what they would have been. Sony's whole operation was done endoscopically, via the throat, so all the repairs to the esophagus must be just to the inside surface. Sony said he was told the 'bands' would dissolve, or fall off naturally in few weeks (I'm not sure which). Also, I have no idea what these "bands" are that the doctor was referring to. Every time I look up the word bands and esophagus on google, I get a bunch of info about laparoscopic surgery, obviously not the same. Do you have any idea what the doctor would have used?

Sony is really really weak and hungry, but the 'diet' seems medieval. Is there any more realistic post-op diet available for Sony that wouldn't jeopardize the operation? I still believe he needs to stick to a liquid diet, but those can be more pleasant to endure than rice water. Personally I'd make him a nice alkalizing veggie broth, some fresh squeezed green drinks, maybe diluted wheat grass, and some kind of power shake with whey and non fat milk, or a smoothie or something. Then move him into well cooked vegetable soups for the third week, and soft foods for before returning to a normal diet. Maybe stay away from things that tend to stick like bread AND rice. What do you think? We have to feed the children even if this one happens to be 35 years old.

[treader]

Hi,

I really appreciate your taking the time for the post. I just don't like to see my friend in pain, or, in this case, extreme hunger. As I wrote in the OP Sony hasn't really had anything to eat in an extremely long time. He also lost a lot of blood through bleeding, and was given 3 blood transfusions each containing 250cc whole blood. On the other hand I don't want to kill my friend through my good intentions.

But this is Thailand, and something else is going on here. The IVs they give are extremely week, and they wouldn't hear of feeding him through TPN Total Parenteral Nutrition. They just say, "That's for cancer patients". Again, you're right, I'm a layperson, but have no idea why they wouldn't want to build up an emaciated person that way. What he is going through is like a prolonged fast. And I know there are many dangers - including life-long heart complications from such fasts. In the US, at least they would be giving the patient vitamins, minerals, and other nutritional items, here it's just a bag of glucose with a small amount of electrolytes.

I went from a fat 265 lbs to an emaciated 165 lbs from rectal bleeding for 4 months in 1998 and they put me in the hospital for 5 days almost solely for TPN. In addition they gave me my 2nd colonoscopy in 3 months and did some blood tests. BTW in 1998 for 5 days in a private room in the US with the above medications & procedures cost me about $20,000. My friend had the operation and 4 days in the hospital in Thailand and the total price was about $2500 in Thailand.

In the case of the doctor this time, I feel God has really blessed my friend. He could easily have died 2 years ago. But then his greatest enemy was himself - his distrust of doctors added to his not eating, and becoming irrational, added to his extreme stubbornness made him not go to the doctor until the last minute. Then you never know what kind of doctor your going to get. The first one bungled the job, then, aided by some other doctors, bungled the second job. Other doctors here operate with a license that they bought illegally. However this time these operations were all carried out in hospitals that would preclude that from ever happening. But a person can become a licensed surgeon here with many less years of training, and on the job experience than in the US. Some of the finer hospitals around are staffed mostly with foreign-trained doctors.

So, I'm very happy that things worked out the way they did this time.
Again, Thanks for your compassion and reply. - Treader

[ggreg]

Well, you have good intentions and creative ideas for what Sony should be eating, but try to keep in mind that an operation on the esophagus, particularly since it's the third op, is a very serious matter.  If Sony consumes anything other than what the doc says, he has a chance of not only losing his whole esophagus, but also his life.  Sony will do just fine on the rice water diet, and if he gets too weak from lack of food, the docs can always hook him up to an I.V. and feed him thru his tummy or intravenously.  By the way, it is perfectly normal for people who have operations, even ones other than on the throat or digestive tract, to not have ANYthing to take by mouth for a week or more, and even then they VERY slowly reintroduce liquids, then soft diet, and so forth.  People who have surgery typically lose a lot of weight in the hospital becuz of how slow the docs reintroduce regular food.

Since his op is in the esophagus, do not be surprised if he has to stay on that rice water diet until the surgical site has COMPLETELY healed.  It is just too risky to jeopardize the health of his esophagus.  I mean, gosh, imagine if you could never swallow again, or eat food again, or if infection sets in and you could never talk again!  When you weigh those possibilities against Sony not eating regular stuff for a while, so be it.  He's lucky he didn't die when he got the glass in there in the first place.  Stick to what the doc advises, he's had a lot of training and experience.  Even tho we, as laypersons, are perfectly intelligent, the doc knows about surgery and post-op care, and until you feel like YOU could cut open a person's throat and operate, respect the doc's wishes and try not to kill his patient.