Nutrition During Chemotherapy

During chemotherapy, patients may experience taste and appetite changes and a heightened sensitivity to odors. They usually complain of a "metallic taste" during treatment. Cancer and its treatments can cause changes in your senses of taste and smell. That is why while they are under treatment, we usually give them "tips" to make sure that they still get their daily nutrition.

Tips:

1. Try sugar-free lemon drops, gum, or mints.
2. Try fresh or frozen fruits and vegetables instead of canned.
3. Try flavoring foods with new tastes or spices - with chili powder, basil, oregano, rosemary, barbecue sauce, mustard or catsup.
4. Rinse your mouth with baking soda mouthwash before eating to help improve the tastes of foods. (Mix 1 teaspoon salt and 1 teaspoon baking soda in 1 quart water. Shake well before swishing and spitting.)
5. Keep your mouth clean and brush your teeth with a soft bristled toothbrush and non-mint-flavored toothpaste to help ease bad tastes.
6. Serve foods cold or at room temperature. This can decrease the foods’ tastes and smells, making them easier to tolerate. (We always encourage ice cream!)
7. Freeze fruits such as cantaloupe, grapes, oranges, and watermelon, and eat them as frozen treats.
8. If red meats taste strange, try other protein-rich foods such as chicken, fish, eggs, or cheese.
9. Blend fresh fruits into shakes, ice cream, or yogurt.
10. You might find eating fresh pineapple helps keep your mouth fresh and moist.
11. Keep your mouth and food moist. Add gravies and sauces to your food to make swallowing easier.
12. Try marinating food, or using strongly flavoured sauces to go with food.

Cold food is better than warm hot ones mainly because hot foods usually have a strong smell and can make the patient nauseous. At the place I work, we usually make smoothies for them. We also found out that ginger, either as ginger biscuits, ginger tea or ginger beer can reduce feelings of sickness.

Bottom line is eat what appeals to you during this time. There is a Hippocratic principle that states: "Let your medicine be your food and your food be your medicine." In other words, eating right will keep your body in good fighting condition.

Reading and Kids

I was walking along the hospital hallway when I overheard an 8 or 9 year old kid complaining to his mom that reading is sooooo boring which of course earned a long litany from the mom how reading is important. Being a mom myself, I also encounter such complaints from my little one.

Gone are the days when kids curled up with a nice little book when it was too hot to play outside. Today, students spend any free time they have watching TV, going to the mall, tinkering with their mobile phones or playing video games. More and more parents are having a hard time encouraging them to read. Getting them to read books just for the sheer pleasure of reading is especially harder since kids just don’t seem to realize how important reading is.

Parents are now trying to find creative ways on how to encourage reading. Some of them they provide a book allowance, others get subscriptions to a magazine for their child. Others (like myself) they do "model reading".

The many benefits your students could reap from reading regularly should make the challenge of making them read a small price to pay. Consider the following:

- Reading develops a person’s creativity.
- Developing good reading skills can improve your students’ ability to understand concepts and ideas.
- Reading develops critical thinking, thus, ensuring that your students will be able to think and make good decisions for themselves.
- Reading introduces your students to new things and has the ability to broaden their interests.
- Reading regularly increases the vocabulary.

So, buckle up parents. You can do this. =)

Weight Loss

OK. You're fat and miserable. You don't know what to do. You feel that the world is coming to an end. You hate yourself. You need help. You resort to the quick fix, lose weight in a week thing.

It is no surprise that the weight loss industry is booming. I have read that "the weight loss industry is an industry that is like a carnivorous animal that feeds on people´s desperation to lose weight and to live healthy lives". I find this all true. Peope are finding ways to achieve that perfect health body. There are tons and tons of recommendations from God knows who - from herbal teas, to diet pills, to diets, to exercise. Name it. Someone would find a way to create it....and people would buy it.

Being a member of "women who need to lose weight", I find this so true... I don't know how many books that I have read, how many diets that I have tried. Because of one thing - to achieve that body that I crave for...

Let's review these products:

1. Diet Pills

There are tons and tons of diet pills in the market today. Each of them claiming that it will stop your body from absorbing the fat that you eat or they will claim that the pill will sent a trigger in your brain to stop you from craving that piece of chocalte cake. To this I say, be very careful.. When you read, "These statements have not been evaluated by the Food and Drug Adminstration" printed in that diet bottle that should be enough to give you warning bells. And please... please remember not all natural sources are deemed safe. A rare plant from Timbuktu doesn't mean that it can give you that magic formula to attain that "oh so gorgeous body".

2. Slimming Pants

Please. Not true. These products just cover whatever you want to hide. They may also be dangerous and uncomfortable. It does not let your skin breathe, and can lead to overheating and dizziness.

3. Slimming Creams

This has to be one of the biggest frauds seen anywhere in any industry. The idea was that by rubbing this cream on certain areas of your body would enable you to reduce fat. Weight loss occurs when you are burning more calories than you are consuming, it is that simple.
Don't sit back and just wait for your problems to magically disappear. There is no quick fix. You need to accpet that you do need to change your ways and lead a better life for a healthier you. Being aware of your weight does not mean that you have to be a size 2 in order to be happy, but it means finding a size that suits you and that brings your body to a state of health and balance

Diet for IBS

I had two patients last week who were newly diagnosed with IBS. Both are in their mid 20's and as soon as the doctor told them their diagnosis, they were devastated. One of them even commented that "he's got no life anymore". That prompted me to educate them more about IBS and specifically the diet for IBS.

IBS is Irritable Bowel Syndrome. The most common symptoms of IBS is pain or discomfort in the abdomen often reported as cramping, bloating, gas, diarrhea, and/or constipation. It primarily affects the colon or the large bowel where we store stool. Simply put, IBS means the bowels are not working or functioning correctly.

The things is with IBS, there is no single food that causes IBS. Not unlike celiac disease where you should just be on a gluten free diet and that's it. A flare up of IBS is caused by any food that is high in insoluble fiber, fat, caffeine or alcohol - these are the "trigger foods". They directly affect the muscles in your colon and can lead to pain, gas, constipation and diarrhea.

If you have been suffering from IBS or if you are just recently diagnosed, I suggest that you arm yourself with everything about IBS. The only way to beath the enemy is TO KNOW THE ENEMY. The following are the usual IBS triggers - and yes, some of them you have to completely take out of your diet but no worry there are substitutions (thank GOD!) and some of them you have to eat in small quantities. The top three categories are the following:

1. Red Meat
2. Dairy Products
3. Egg yolk

The very high fat content of the above mentioned at times causes severe spasms which triggers diarrhea and intolerable pain.

So, the key is to have a low fat and high soluble fiber diet. The soluble fiber forms a thick gel which absorbs excess water as it passes through the intestinal tract. This reduction in water helps reduce diarrhea. Plus, the bulky fibrous mass gives the GI muscles something to "hold" during movements that push food along the intestinal passage (called "peristaltic contractions"). Typically, this prevents the uncontrollable bowel movements characteristic of diarrhea.

What are again the foods that needs to be avoided?

Caffeine (found in tea, coffee and soda)
Dairy products
Red meats
Gluten (a protein found in wheat, barley and rye)
Alcohol
Fried foods
Citrus fruits
Chocolate
Any foods high in fat

What foods should you eat on a diet for IBS? Foods high in fiber such as:

Fresh fruits and vegetables.
Beans like kidney beans and lima beans.
Whole-grain breads and cereals.

Also, it is important that when you are on a diet for IBS, you have to eat smaller meals, which will reduce or prevent bloating. Drink plenty of water. Savor your food. Don't eat too quickly - this may cause you to have more gas (because basically you are swallowing more air).

Now, everyone is unique. What maybe fine for Carlos might not be good for John. Not everyone with IBS has problems with all of these foods. It will help a lot if you have a FOOD DIARY so you can list what foods cause your IBS to flare up. Whenever you have problems, make a list of what you ate last. This will enable you to create your own personal list of what you should and should not eat.

A diet for IBS doesn't mean you can't eat foods that you like. It just means you have to pay more attention to what you eat and to what foods trigger your condition.... and only then you will realize that this is not the end of the world =)

Gardasil

I was watching Anderson Cooper's 360 when I saw that he had a segment about Gardasil. Gardasil is a vaccine against cervical cancer...and it has just been approved by FDA. WoW! This marks a very important step forward in women's health.

Eversince I became an oncology nurse, my eyes opened on the importance of cancer prevention. I have seen enough of cancer victims that every night I pray that they would find a cure for cancer... And the emergence of Gardasil is a blessing.

Gardasil is a vaccine that helps protect against diseases cause by HPV (Human Papilloma Virus). HPV causes cervical cancer, genital warts and abnormanl/precancerous cervical,vaginal and vulvar lesions. Their primary target population for this vaccine would be predominantly females between the ages of 11-13. But Merck and Co. is saying that the vaccine could also help those people who has HPV.

Now, this has set up a clash between health advocates who want to use the shots aggressively and social conservatives who are citing fears that it could send a subtle message of encouraging sexual activity before marriage.

I don't know but I think the vaccine is great. It would help prevent a cancer that kills a large number of women each year....and that having your pre-teen vaccinated with this could also be an avenue for you too to talk about sex.

National Cervical Cancer Coalition likened the vaccine to wearing a seat belt. As they say,"Just because you wear a seat belt doesn't mean you're seeking out an accident,".

No one could have said it better.

Low salt and low sodium diet

You may have heard your doctor or nurse talk about a low-sodium or a low-salt diet and may wonder whether they are different diets. There is actually no difference between the two. Doctors and nurses usually use the terms sodium and salt to mean the same thing.

It is important to decrease the amount of sodium you eat when you have heart failure, because heart failure causes the body to hold on to extra sodium. The sodium causes extra fluid to build up in your body. The extra fluid makes your heart work harder. That's why you have those heart failure symptoms - because of excess water.

Here are some tips to lower your salt and sodium intake:

1. Be aware when you are grocery shopping. READ THE LABEL. Look for foods that are labeled "low-sodium," "sodium-free," "no salt added," or "unsalted." Check the total sodium content. Be especially careful of canned, packaged, and frozen foods.

2. Don’t cook with salt or don't overdo. Try pepper, garlic, lemon, or other spices for flavor instead. Be careful of packaged spice blends as these often contain salt or salt products (like monosodium glutamate, MSG).

3. Avoid foods that are naturally high in sodium, like anchovies, meats (particularly cured meats, bacon, hot dogs, sausage, bologna, ham, and salami), nuts, olives, pickles, canned meats, sauerkraut, soy and Worcestershire sauces, tomato and other vegetable juices, and cheese.
Take care when eating out. Stick to steamed, grilled, baked, boiled, and broiled foods with no added salt, sauce, or cheese.

4. Use oil and vinegar, rather than bottled dressings, on salads.

5. Eat fresh fruit or sorbet when having dessert.

Other conditions that may benefit from a low-salt diet include Ménière’s disease, migraine, gastritis, ulcers and kidney stones to name a few. Some researches also suggests that restricting dietary salt may play a role in the prevention of certain types of cancer including stomach, colorectal, and head and neck cancers.

Restrict high-sodium foods to a tiny corner of your pantry, and use the new wide open space to stock up on food that’s good for you. It's just a matter of getting used to. Soon, your taste buds will perk up, and your health risks will go down.

Heart Failure

I know the term "heart failure" doesn't sound real good but what heart failure means that the heart's pumping power is weaker than normal. It is NOT cardiac arrest. Cardiac arrest means the heart actually stops beating. Heart failure is also called congestive heart failure, or CHF. "Congestive" means fluid is starting to build up in the body because the heart isn't pumping properly.

There are different causes of heart failure. It could be one of the following:

-High blood pressure (hypertension)
-Coronary artery disease (narrowing of the blood vessels to the heart )
-Heart muscle problems(known as cardiomyopathy)
-Alcohol abuse
-Congenital heart disease (a heart problem you were born with)
-Diabetes
-Thyroid problems

What do we need to watch out for?

1. Rapid weight gain
2. Shortness of breath with any activity at all
3. Shortness of breath when laying down
4. Swelling of the legs or ankles
5. Waking up in the night suddenly breathless

With these symptoms, it is best to go to your doctor. He would usually order an EKG or an Electrocardiogram to determine your heart's functioning ability. Heart failure can't be completely cured (it's like hypertension). An important part of treatment is taking care of any underlying problems first. It also includes lifestyle changes and medicines.

Your medicine would depend on the symptom that you are manifesting. Your doctor might give you the following meds:


ACE inhibitors. ACE inhibitors help open your arteries and lower your blood pressure thus improving blood flow.
Diuretics. Diuretics or "water pills". This medication would make you urinate more often and help keep fluid from building up in your body. They can also decrease fluid that collects in your lungs, which helps you breathe easier.
Beta blockers. Beta blockers can improve blood flow and may help prevent some heart rhythm problems.
Digoxin. Digoxin (also called digitalis) helps the heart pump better.

Lifestyle changes includes:

1. Limit salt and sodium intake.
2. Don’t smoke.
3. Exercise. Stay active. Your doctor can provide a safe and effective exercise plan based on your degree of heart failure and how well you do on tests that check the strength and function of your heart. DO NOT exercise on days that your weight has gone up from fluid retention or you are not feeling well.
4. Lose weight if you are overweight.
5. Get enough rest, including after exercise, eating, or other activities. This allows your heart to rest as well.

Heart failure can be frightening. It has no cure, but one can live a full and enjoyable life with the right treatment and active attention to your lifestyle.

In Charge With Diabetes

Everybody has sugar in our body. Sugar is use for energy... But too much sugar is not good. It can mean diabetes. Normally, your body breaks food down into sugar. Then, your pancreas makes a hormone called insulin. Its main function is to help get the sugar from the blood into the cells to be used for fuel and energy. Insulin helps keep blood sugar in check.

According to the American Diabetes Association, more than one out of every three individuals in the United States have diabetes. Diabetes is a disease in which the body does not produce or properly use insulin. There are three types of Diabetes - Type 1, Type 2 and Gestational diabetes

In type 1, the pancreas stops making insulin. Without insulin, the cells in your body can't use food properly. Because glucose can not enter the cells, it builds up in the blood and the body's cells literally starve to death hence, there is extreme hunger but loss of weight in these individuals.

In type 2 diabetes, either the pancreas does not make enough insulin or the body is unable to use insulin correctly. It usually begins gradually and progresses slowly. Often than not, you are asymptomatic - meaning you don't know that you already have diabetes.

Gestational is a type of diabetes that some women develop during pregnancy. When pregnant, your hormones make it tougher for your body to use insulin, so your pancreas needs to produce more of it. As your need for insulin increases, your pancreas secretes more of it. But when a woman's pancreas can't keep up with the insulin demand and her blood glucose levels get too high, the result is gestational diabetes.

I remember when my mom was diagnosed with Type 2 diabetes a few years back. She was in denial at first which is understandable. When she was told that she has diabetes, what she pictured was that she will be reprimanded from eating her favorite - chocolates! The first year was hard. I had to talk to her several times. She hated it with passion. She had a hard time checking what she eats.

People with diabetes can eat the same foods as the rest of the family. They key is choosing foods properly and eating reasonable portions to keep your blood sugar on track and reach your target weight. There are lots and lots of food right now in the market that targeted for the diabetic population. You can even have desserts!

Read food labels carefully! Sugar-free does not always mean carbohydrate-free. This also goes with fat free foods. Fat-free foods can be higher in carbohydrate and contain almost the same calories as the foods they replace. One good example of this are fat-free cookies.


Exercise is a biggie. People with diabetes need to be active. Activity helps keep your blood sugar levels down. Regular exercises can help your body respond to insulin and is effective in managing blood glucose. It can lower blood glucose and possibly reduce the amount of medication you need to treat diabetes, or sometimes, even eliminate the need for medication.

You can be healthy and happy with diabetes.

You just have to be in charge.