How cancer has affected my dietary habits

A year ago, I wrote the following as a facebook post:

The most wonderful thing about dealing with cancer and its treatment are the strange side effects that pop up. My previous radiation treatments resulted in a group of side effects like a esophagocutaneous fistula, mandible necrosis, trismus, radiation fibrosis, extreme dental caries, etc. With new things pooping up randomly and with out warning. And now a new round of radiation is going to begin on 18 July so there will probably be more things to make life more interesting for me.

A new symptom has popped up since my latest surgery: "first bite syndrome." Imagine that on occasion(and you never know when or if it will happen) when taking a bite, you get the most excruciating pain imaginable in your jaw! A pain that can bring you to your knees, tears to your eyes, and make your brain feel as if it is shattering, with shards of razor sharp glass penetrating deep into the jaw and surrounding tissues. The worst thing is that you never know what will trigger this pain. Yaaaay(extreme sarcasm here)!!!!!

https://www.oncolink.org/.../side.../first-bite-syndrome....

This year I reposted this with the following added:

 It happens every time I eat now, unless I am religious in taking my oxycodone. It makes me a little dozy but I can eat without having a stabbing pain with every bite.

This post was from when I was still eating via a feeding tube, before I discovered that I had a constricted esophagus. It was 0.5cm when discovered. I have had multiple dilations, and learned that after a dilation, the damned thing will shrink again. 1.9cm is the largest my surgeon has gotten it. But it seems to reach statis at 1.25cm.

I have finally asked to be taught self-dilation. This is so I can eat somewhat normal food again.

Every meal takes inordinate amount of care when cutting up food, chewing, and what goes in my mouth. Any 'normal' amount of food turns into a massive traffic jam once I try to swallow and try to get in to go into my esophagus. Imagine the mouth as the chamber or large part of a funnel, and the smallest part of the funnel is my esophagus. Everything I eat has to be forced through the tiny opening of the funnel. If I could take a stick and poke it all through, that would be great. As it is, I need to block my stoma, then 'blow'/force air through my tracheoesophageal puncture to push any blockage back into my mouth. This normally works well. Sometimes it can be messy, especially if there is too much liquid in the blockage. Either way, it makes for interesting mealtimes if someone is unaware of my condition.

I have lost much of my saliva production too. At least the type of saliva which helps redigest many foods. Like sugars, and greasy foods. Imagine eating some delicious meats and have it go in your mouth and then it feels like someone just paints the inside of your mouth with grease that does not go away. Saliva helps break it down normally.

Same with sweets, the sugars coat what they touch, leaving behind a sticky coating. Licking your lips helps remove this when saliva is normal.

Same with eating. Saliva helps form chewed food into an easy-to-swallow bolus, without it, food is a mass that doesn't hold together nor go down easily. This necessitates massive amounts of water to be consumed with each meal, and such a long time taken to consume a normal amount of food.

I'm also seriously lacking the digestive enzyme, amylase, from my saliva. It helps with the preliminary breakdown of starches and other complex sugars into simple sugars like glucose and maltose. So my lips will feel sticky after consuming anything sweet and with most folks, licking one's lips will remedy the problem, I cannot. So I need to wash my lips after eating.

Spicy foods burn my tongue now. After the partial glossectomy last May and during the robotic procedures, my tongue's anatomy has slightly shifted and has become more sensitive to acidic and 'hot'/capsaicin foods. Part of this is due to the saliva shortage and its ability to alter and "mute" the effect of these food chemicals upon the structure and sensitivity of the altered tongue. Either way, I miss my hot peppers, and why do the best things have vinegar as part of their make-up??? My tongue now registers fricking ketchup as spicy!!! WTF?!? I have learned to make the necessary adjustments.

OMG, I just realized that I have not had any Joe's BBQ since my surgery last May. I wonder how I will react to the famed vinegar/red pepper sauce used in our famous Eastern NC BBQ? I did make a rack of pork spareribs last weekend and used a Eastern NC sauce on it. Went really heavy with the sauce, and my son greatly appreciated it as I ate a small portion of the meat and gave him the rest!

After I came home from my long stay in Charleston for cancer treatments, it took a while to settle on a menu that worked for me considering my various health issues. I would pour a layer of breakfast cereal into a container. Then add ice cream. Butter pecan(or very rarely, butter almond) is the only one that is really palatable and I could eat for longer than a few days at a time. Then I would pour a bottle of Equate(wallyworld brand) meal replacement drink over the ice cream. If done right, the drink would form an icy crust over the ice cream, and give a nice texture contrast to this meal concoction. Egg drop soup with extra fried noodles is another favorite

Another thing with eating is I only need half the amount I used to eat. I think that the immense amount of time needed to consume a simple meal makes the mind think it is full with a lesser amount of food.

A large bowl of this once a day later in the afternoon. A large coffee in the morning with another Equate drink. Maybe an attempt with chips/crisps, or crackers, later in the evening. This constituted my entire diet for over 9 months.

My recent trip to the UK was the first time that I was in a position where I had to try eat normal foods. Many meats are now off my list due to the greasiness factor. This I realized as I tried my tried and true favorites across the pond. And some I tried repeatedly just in case I was experiencing some strange anomaly with some things. Fish & chips became just fish as the chips were too starchy for me to get down. And a few times I asked for just the crunchy bits. And there are too sizes for more foods--large and fucking huge! I could not get places to give me a half portion of anything. How hard is it to put half the food in a container for half the price?

Ok, gonna stop going on about the changes I've been dealing with as I have a whole new group of surgeries, treatments, and scars to deal with soon enough. Though since my lung cancer is in upper left lobe, that side of my chest is already wrecked from the pectoral flap fistula repair thus not much more damage can be done. I do have some awesome damned scars though!

Salivary Glands

Definition

A salivary gland is a tissue in our mouths that expels saliva. You can feel your salivary glands activate when you eat something really sweet. As exocrine glands, they expel saliva into our mouths by way of ducts. Each day, our glands produce as much as a quart of saliva.

Overview

Saliva is a mixture of water, mucus, antibacterial substances, and digestive enzymes. One of the most recognizable digestive enzymes in human saliva is amylase. This enzyme is able to break down the starch in our food to simpler and more easily digestible sugars like glucose and maltose. Whenever we chew, we are activating salivary glands in preparation for the breakdown of our meal.

Salivary Glands

Saliva has a number of functions within the digestive system beyond breaking down starches. Saliva also helps keep our mouth and digestive tract lubricated, which ensures it functions properly. Salivary glands typically function without issue, but a blockage or infection within the salivary glands can cause significant pain and discomfort.

The salivary glands are located in several areas around the mouth and have ducts connected to both the upper and lower jaw. This ensures that saliva evenly coats the inner lining of the mouth. You can feel the end of these ducts just below your tongue and along the inside of your upper lip. If you eat something with a lot of starch or sugar, you can also feel the salivary glands activating and releasing saliva.

Salivary Glands Function

Briefly, saliva itself serves many uses. As the only secretion of our salivary glands, it is helpful in creating the food bolus, or the finely packed ball of food that we roll inside our mouths. This shape facilitates its safe passage through our alimentary canal. Saliva has lubricating properties that are protective, as well. Saliva protects the inside of our mouths, our teeth, and our throats as we begin to swallow the bolus. It also cleanses the mouth after a meal and dissolves food into chemicals that we perceive as taste.

                                     Salivary Gland Location

Salivary glands come in three types: the parotid, sublingual, and submandibular glands. Each is aptly named after the area in the oral cavity in which it is located. Let’s begin this discussion with the parotid gland.

Three types of salivary glands

The diagram depicts the three types of salivary glands in the mouth: 1) parotid glands, 2) submandibular gland, 3) sublingual gland.

Parotid Glands

The two parotid glands are located within each of our cheeks. Parotid glands are the largest type of salivary gland. They account for up to twenty percent of the saliva in our oral cavity. Their main role lies in facilitating mastication, or “chewing,” and in commencing the first digestive phase of our food. The parotid gland is notably labeled a serous type of gland. Serous glands are those that secrete protein-rich fluid, which in this case is an enzyme-rich suspension of alpha-amylase.

Submandibular Gland

Next, the submandibular gland is located close to our mandible. This is the movable part of our jaw. In essence, this gland lies on the floor of our mouths. Since it is superficially located, we can feel it if we place our fingers about two inches above the Adam’s apple. It is the second-largest salivary gland and produces the most saliva (up to 65%). It is considered a mixture of serous and mucous glands since the suspension is both rich in enzymes and gooey mucus that is released into the oral cavity through the submandibular ducts.

Sublingual Glands

Lastly, sublingual glands are located under the tongue. They are the smallest and most dispersed salivary gland. They secrete mostly mucus, which exits directly through the Rivinus ducts. Only a minimal (~5%) amount of saliva in the oral cavity comes from these salivary glands.