Exhausted!

[Ilfc2022]

76yr old male, 15months post oesophagectomy, eating same diet as pre cancer but obviously far less. Taking 20mg Omeprasole daily, no reflux issues at all. Struggling to maintain weight, 82kg pre-op, 66kg now. Main problem is exhaustion. Go to sleep after almost every meal, then have maximum 1hour to try to do something, then it’s time to eat again and the cycle starts again! Anyone with same symptoms? Any ideas?

[purplekey]

Hi I am 2 and half years post op, I have only felt more like my self for the past 4 months, no more having to sit down and resting or having a sleep after doing light jobs in garden/light house work for half an hour! Things get better very slowly and at about 15 months I too like you thought ‘this is it! ‘. I can eat a bit more now than I could 6 months ago too and feel and look healthier even though my weight has not gone up but it’s not gone down for 18 months. I too have to time activity between meals, it is a full time job! But I’m now accept this is my new life and I can’t go back to my old ways. This time next year I’m sure you too will feel a lot better. We’ve had a huge op and it takes longer than the drs think to recover as of course they’ve not had it. Make sure you are drinking enough ( I have to time in my drinks too otherwise I forget, keep up your protein levels to help you heal. I have protein powders to add to porridge and milky drinks. Did your dietician prescribe a multivitamin too. Good luck x

[Ilfc2022 in reply to purplekey]

Thanks! I do have a multi vitamin, you make my experience sound normal. Very reassuring.

[kiddy]

Hi there, Yes we have been through a major op. Are you drinking with your meals or eating too much fat or sugar. This can have the effect of dumping syndrome where you want to sleep.

I eat like a child and snacks like cheese and biscuits, banana etc throughout the day. Do you get bloods checked every 3 months to see your levels. I needed iron supplements as not absorbing enough nutrients. Your weight might increase as time goes by. I am 7 years post op and weigh a stone under what I was before operation.

Our new life is a bit of a roller coaster but gradually live to enjoy .

Take light exercise if you can.

Best Wishes

Debbie

[Ilfc2022 in reply to kiddy]

Thanks, I’ll follow up on the iron checks.

[FKM100]

Hi, I had the op mid-2020 and am doing quite well, although I have had to adjust to a whole new style of eating - as we all do.

One common problem is food passing too quickly through what, if anything, is left of our stomachs, leading to the body producing too much insulin and consequent hypoglycaemia (this is one facet of what is commonly called 'dumping' syndrome). This can make you feel weak and sleepy (not to be confused with actual fatigue, though) and even pass out. Here it helps to eat only small amounts at a time, avoid food with a high glycaemic index, and don't drink anything with or directly after a meal - this just acts as a 'chaser' and you certainly don't want that. If it keeps happening, you can speak to your doctor about prescribing acarbose, although it would probably be wise to try adjusting your diet first.

Another common problem, especially if we take Omeprasole or other PPI, is reduction in the ability to absorb the nutrients that are normally absorbed in the stomach - such as vit B12. This in turn can lead to iron deficiency, anaemia and real exhaustion. A blood test can pick up if this is the case. Sadly, nutritional supplements may not be a lot of help here, because of the malabsorption issue, but you can get vit B12 jabs which will circumvent this problem. The fact that you say the problem happens after every meal makes me think it is most likely the result of dumping, though, rather than vitamin deficiency. Still, you never know. Maybe raise it with your doctor when you have your next appointment.

I hope this helps and good luck.

[Ilfc2022 in reply to FKM100]

Thanks for your comments. Clearest explanation I’ve ever seen, very helpful, thanks.

[FKM100 in reply to Ilfc2022]

Glad I could help. All the best.

[Spikey]

I think many of us have experienced similar issues. It sounds as though you are doing very well - eating the same as before and no reflux. Don't worry about your weight. I was 75kg pre-op and am now 60kg, but am fit and well and still here 16 years later. The tiredness will get better - it took me roughly two years to get any energy back (and I was only 54 at the time of my surgery). As others have suggested, avoid foods with a high glycaemic index, in case it is mild hypoglycaemia, and take regular exercise.

[Ilfc2022 in reply to Spikey]

Thanks for the support. Reassuring.

[grandylynda]

Sounds about right for 15 months. It's a slow process. Avoid too much fat or sugar . I do find myself with takeaway drinks often, fsometimes from home, otherwise it is difficult to fit in enough liquid away from eating. I am 6 yes post op and am now maintaining my weight at about a stone less than before surgery. Like others I have multi vitamins, iron supLament and creon. It was the last that finally helped me gain a bit more weight. Be patient and try to stay positive. Accept all help

Offered and don't be afraid to ask

[Ilfc2022 in reply to grandylynda]

Thank you.