Tag: nutrition

Bobs Bowel 7 – Outpatients Anaesthetics


Thursday 13th February, and another appointment. Once again, at the Queen Alexandra Hospital. I’ll soon have my own allocated parking space if my visits carry on at this rate.

This time my appointment is with an anaesthetist in the Outpatients department.

My appointment was at 10:00, and right on the button, I was whisked away for some observations. I had my blood pressure, weight, and height measured, again. I was also given an ECG.  And then it was back to the waiting room where I had time to make friends, playing peek-a-boo with a toddler.

After a short while my name was called by the anaesthetist wearing an amazing pair of electric blue shoes.

After the usual pleasantries she revealed that we had met before. Ten years ago, when I went in for the brachytherapy treatment for my prostate. She was the anaesthetist who drew the short straw for my procedure. As a patient I was not very cooperative, not on purpose. With me sat on the table in theatre she attempted to give me an epidural. Three times!! My body just refused to play ball, would not give up my spinal fluid so no further attempts were made.

Once the procedure was underway it was time for me to misbehave again. I unconciously decided to vomit. She unfortunately had to deal with that, and call in Dynarod to suck out my tubes.

I apologised to her as in my head I was to blame, having had rather a lot of cheese as my last meal the night  before the procedure. Nobody told me that they tilted you head down to insert the nuclear seeds. She showed me the copious notes taken following that little episode but she was quite magnanimous. Noting my, as yet undiagnosed, type 2 diabetes which apparently can have the effect of slowing down your stomach process, causing “pooling” which in turn can cause regurgitation.

After reminiscing about old times we got down to the business in hand. We had the inevitable chat about my health in general and specifically focussing on weight, fitness and diet.

I was given a thorough but gentle arse kicking. Likening preparing for the operation to an athlete preparing for the olympics. Apparently the procedure will last about four hours and, although I will be unconcious laid out on the table, for my body it will be akin to running against Usain Bolt. So, as she put it, I need to be in the best possible shape to deal with the procedure but also the fitter I am the faster I will recover.

Exercise and weight loss are the order of the day, supplemented by plenty of practice with my spirometer. She wants me to up my daily walking. That shouldn’t be hard since it is negligible at the moment.

We also talked about diet with regard to my diabetes which can have a negative impact on my post op recovery. And right there is where I get into trouble.

In general the medics extol the benefits of a balanced diet, with plenty of fruit, vegetables, nuts, seeds and so forth. Quite often promoted as the mediterranean diet. Below is a typical chart promoting a balance diet. All stuff that I like.

Due to the location of my tumour which is partially blocking my bowel I have been advised to stay on a low residue diet which conflicts with the idea of a balanced diet. Which in turn also conflicts with a diabetic friendly diet.

What that means is that the only food that I can eat from the green zone is carrots which have been peeled and cooked until they are soft. I can have cucumber but I have to peel it and scoop out the seeds. From the yellow zone I cannot eat any of the wholegrain items. I can have potatoes cooked without their skins and not shown I can have white bread, rice and pasta.

Hang on a bit, actually, for my diabetes I should not be eating any quantity of carbohydrates as this gets turned into sugar, bad for diabetics. So between the diabetes and my tumour everything in the yellow zone is pretty much a no-no.

Things do get a little better when we look at that strange pink zone. I can eat the tinned tuna, chicken, fish, eggs, and mince. Although my tumour says no to fish skin and bones like you might get with sardines and pilchards. Meat is fine but no gristly bits, no bacon rind etc.

And on to the blue zone where I am allowed small amounts of cheese and milk.

And so, I am resigned to eating a mainly protein diet, not quite leaping into the full carnivor diet. Supplemented by squidgy overcooked root vegetables.

As if meal preparation wasn’t already difficult enough.

Ah well, as the anaesthetist says, it is only for a few weeks.

Sad to say, I still don’t have a date for my op.

Bobs Bowel 5 – Surgery School


Monday 3rd February and the preparations for my impending surgery continue apace. The latest adventure was a two hour class at Surgery School.

I know the NHS is constantly strapped for cash but putting me through a crash course in surgery doesn’t exactly fill me with confidence that my outcome will be positive.

Of course the aim is not for me to carry out DIY surgery. No this session was all about preparing me for surgery and getting me as fit as possible both for the procedure and the recovery period after.

Getting fitter, they say, will help reduce the risks associated with the surgery. Risks such as chest infection, blood clots, kidney problems, wound infection / healing.

To this end the speakers were focusing on exercise and nutrition, the importance of a balanced diet. Unfortunately, my cancer is such that it is partially blocking my bowel. Because of this I am continuing on a low residue diet which means I cannot eat many of the “healthy” foods. No wholegrain breads, no high fibre vegetables such as onions, leeks, cabbages, and cauliflower. Also many of my favourite salad vegetables such as tomatoes, peppers, radishes, celery and baby corn are excluded. In addition to the low residue diet I am also on a course of laxative, Molaxole. To help keep things moving.

Thankfully I am not a smoker as that is definitely a no-no. Apparently smoking can have detrimental effects on ones ability to heal and also the well publicised impact on the respiratory system.

Similarly, drinking alcohol is frowned upon. My consumption in general has reduced dramatically over the last few years, to the point where I might only have a pint of beer or a glass of wine every week or two. Total abstinence won’t be an issue for me.

Preferably they like patients to totally abstain from drinking and smoking on the run up to surgery and offer help to those who need it.

And finally, that brings me to the contraption in the photo below. No it isn’t some kind of sex toy. This beast is an Incentive Spirometer.

Incentive Spirometer

All folks attending surgery school were given one of these. The purpose is to reduce the risk of lung complications following surgery.

Use of the incentive spirometer is part of the iCOUGH process a program implemented by hospitals nationally and internationally. The acronym ICOUGH stands for: Incentive Spirometry, Coughing and deep breathing, Oral care, Understanding, Getting out of bed at least three times daily, and Head-of-bed elevation. The program emphasizes deep breathing exercises to keep lungs healthy and prevent lung problems. Oral care, patient and family education, getting out of bed, and head-of-bed elevation are also important components of the program.

We were instructed to use this device three time per day prior to surgery, and every hour following surgery.

I still don’t have a date for the actual surgery but the medics are focussed on getting me fit and also preventing me from getting bored.

Bobs Bowel 2


Previous Posts On This Subject

The NHS Poo Sticks game, Colonoscopy, and Bobs Bowel.

I have become obsessed with bowel movements, or rather the lack of them.

After my CTC I restarted taking a laxative, Molaxole, but this was proving to be non productive. As well as the laxative I have also resumed eating normal foods, not the low residue diet, which is remeniscent of baby food.

The lack of bowel movements over the last few days, and the constant feeling that I just ate a full Christmas roast is troubling. The indications are that my tumour is severely restricting the flow in my digestive system.

And that is definitely not good news.

I have been consulting Dr Google, which is not always a good thing. But, in this case the concensus seems to be that, if my tubes are truly blocked, then continuing with the laxative can be counter productive.

Regardless of biopsy results I think it is imperative that the tumour is removed and tout de suite.

As I have been typing this post, and after several fruitless trips to the bathroom, I have finally had success. The fullness that I have been feeling is easing so I think I will carry on with the laxative for the time being. Based on my recent past experience, my bowel seems slow to react. So I have taken another dose of Molaxole and will drink plenty of fluids.

Tomorrow, I will contact the Colorectal Unit for some advice but regardless, I am seeing a consultant on Tuesday with whom there will be a full and frank discussion.

So, I am off now, to make a mug of Bovril.

Stay tuned….

Poo Sticks – Updated


No, not the children’s game immortalised in the Winnie The Pooh stories.

I am referring to the game played by adults of a certain age. The NHS initiates this game. As part of their Bowel Screening Programme they send a package through the post requesting a sample of your poo. You then return it to them and they analyse it.

I’ve played this game with them for several years. Presumably, I was winning because I never heard back from them. No news is good news, right!

That continued until late last year when I was invited to a telephone consultation.

They had discovered some traces of “non visible blood.” The net of that hour long conversation was their decision to offer me a colonoscopy. I say offer because it was left open for me to decline the procedure.

What sort of cretin would I have to be to decline ?

You are 73 years old. Your body is wearing out. When the professionals are concerned enough to contact you, it’s only polite to accept.

And so an appointment was made for a colonoscopy and a package duly arrived in the post. Said package contained several pages of information about the procedure. It also included a blow by blow script for the preceding seven days and three sachets of Picolax.

It seems, understandably, that before a colonoscopy the medics like you to clear your tubes. So, for seven days I had to follow a “low residue/low fibre diet”. That is to say I had to cut out all foods containing fibres which are hard to digest. This helps reduce the amount of undigested food passing into my large bowel.

Adhering to this diet presents extra challenges when preparing meals. Those bad boy fibres are really sneaky, popping up when you least expect them. Also many of them are contained in favourite five a day fruits and vegetables.

For example you can eat potatoes but not the skins. You can eat pretty much any root vegetable, like carrot, swede, and turnip. Just make sure they are peeled and well cooked. They should be soft enough to mash. No peas, beans, citrus fruit or berries etc. and no seeds or grains. Even onions are a no-no. The list is endless.

Over the last few days I have become a nervous food prepper/eater. I was preparing some bell peppers for dinner only to find that they are not allowed. Similarly, on Sunday I was holding a glass of red wine when I decided to consult Dr. Google. Nope, red wine is not allowed, in fact turns out I should be avoiding alcohol in general.

Yes, you can make tasty meals acceptable for a low residue diet. However, they lack texture. They are also missing key ingredients to take the flavour to the max.

And so, here I am, having completed the low residue diet. Looking forward to my colonoscopy tomorrow. To be honest I am actually looking forward to eating real food tomorrow night. Just one more hurdle to cross, well two actually.

Hurdle number one is that today, 24 hours before my procedure, I am not allowed to eat anything. I can only consume clear liquids. These include water, squash, coke, lemonade, black tea/coffee, clear soup, marmite/bovril/oxo mixed into weak drinks with hot water. By this time tomorrow I will so hungry you may find me gnawing on a table leg

Hurdle number two, you may remember that earlier I mentioned Picolax. Picolax is a laxative and I have to consume three doses. The first was at 08:30 this morning. The next dose is scheduled for 12:30 and the last to be taken at 18:30.

Having read the instructions the only thing at the forefront of my mind is “Make sure you are close to a toilet”

Oh well, I suppose it’s all for the best.

Stay tuned.

Today, January 15th, was colonoscopy day.