Preparing for a lifestyle without a stomach

I’ve recently completed chemotherapy, and now have a few weeks before the big surgery. In the meantime, I’ve joined a stomach cancer support group, My Gut Feeling. This group consists of survivors of stomach cancer who are at different points in their journey. Some have just finished chemotherapy, others are years removed from all treatment, but almost all are unified by a lifestyle without a stomach.

Not having a stomach profoundly changes you. Anytime I face an experience that frightens me, knowing what to expect helps alleviate my anxiety. After talking to as many cancer survivors as I could, here are some of the main symptoms I should expect:

Weight loss

The literature suggests that 10-20% of body weight is lost after complete removal of the stomach. This tends to happen over the first 6 to 12 months. By my estimate, given that I am currently 143 lbs, I would need to gain roughly 30 lbs before surgery, if I were to get back to my current weight after surgery.

I’m now trying to eat more than I ever have, and I only have a few weeks to do it. My plan consists of eating all day long, and never let myself be hungry. This strategy will continue to be in place after my gastrectomy, in order to maintain my weight, with the exception of much smaller portion sizes (food storage capacity after a gastrectomy is quite limited). Gone are the days of eating 3 big meals a day.

Eating all day long is a full-time job. I’m slowly trying to incorporate eating into as many aspects of my life as I can. If I’m watching TV, I’m eating at the same time. If I’m commuting, I’ve got a snack in hand. I try to never leave home without protein bars and trail mix. It’ll be more challenging once I return to work seeing patients in a high-pace environment, but for now, I have time to master the Art of Eating All Day Long.

Dumping syndrome

Dumping syndrome is a condition that happens after a gastrectomy whereby food moves very quickly into the small intestine (in the absence of a stomach). Normally after a meal, food is stored in the stomach and is slowly released into the small intestine. Without a stomach, it all gets quickly shoved into the small intestine. This results in bloating, vomiting, diarrhea, feeling light-headed and a host of other uncomfortable GI symptoms. It is often associated with simple sugars (no ice cream for me). Eating more fibres, complex carbohydrates, and delaying liquid intake 30 minutes after a meal seems to help. However, everyone responds differently, and trying to predict the perfect meal to minimize symptoms is a futile exercise. I’ll have to try out the different combinations of ingredients myself.

This is one aspect of life after surgery that I’ve thought little about. It’s hard to envision how my eating habits will change. I’ve never had to worry about what to eat, how fast to eat, and in what order of foods to eat. I wish there was a way for me to figure out my eating style other than by trial and error. The quicker I learn, the smoother it’ll go.

Like most things we take for granted, we don’t realize how much value they bring to our lives  until they’re gone. Will I miss the simplicity and satisfaction of eating 3 large meals a day? Of course I will. But this is a small price to pay for a shot at a cure.

It’s time to let go of the past and look forward a brighter but different future.