Anorexia - Collingswood,NJ

It is my understanding that anorexia is a psychological disorder where people have a distorted body image (thinking they are too fat) and therefore starve themselves to reach their goal of obtaining thinness. Your poor father has esophageal cancer and liver disease. I would imagine it is very difficult for him to swallow food. I know how I feel when I am sick with a cold or stomach virus and how nothing appeals to me and I simply don't feel like eating. Now I am trying to imagine having liver disease and cancer and I can understand why he does not want to or simply can't eat. Have you ask your father's doctors what his prognosis is. Often times when someone is nearing the end of their life (I am not saying this is the case with your father since I am not a doctor and only know what you have written) they loose their appetite as their body starts to shut down. I had an aunt that this happen to and it upset me greatly to see family members shoving food into her mouth. She ended up spitting most of it out anyway and that one spoonful of mashed potatoes certainly did not enhance her quality of life during the time she had left in my opinion.
I sincerely hope that your father gets better but please do not argue with him about food. Just make him as comfortable as possible as he works through these horrible diseases.
Your father and family will be in my prayers.

It is always difficult to see someone you love make choices you feel are against their well being. I am sorry to hear your family is experienceing this. Going through chemo and radiation can really be quite difficult, and there is a psychological effect as well as the physical/physiological. I would reccomend trying to find a support group or online community for people and family who are going through what your father is going through...with liver disease.

Your love and concern comes through so strongly in your letter. I suggest you consider family counseling...perhaps frame it to your dad that it is to help all of you cope with the changes and be a better support for him...If he refuses to go, you still should go.

The doctor is right. An NG tube is quite uncomfortable. It is difficult balancing quality of life with quality of care. Ultimately, your father has his choices to make and they may not be what you want. I am sorry. You can provide him with food options. You can provide him with love and support. You can provide him with counseling. You can provide him with options. As long as he can think for himself though, the choices are his to make.

I wish you all the best. I hope things improve for you all.

My Father had surgery for Barrett's esophagus (pre-cancerous cells lining esophagus from years of reflux) in 1996 and lived until he was 86, died 11 years after the surgery-but not completely related to the surgery. He went from a robust just over 6 ft nearly 200# man to much shorter and about 120-130#. He had a stricture (narrowing) of his new esophagus and eating was painful plus he lost some sense of taste. His Dr put him on anti-depressants that also act as an appetite stimulant. My Father was brilliant and the Dr knew that telling him it was mainly an anti-depressant wouldn't sit well with him so didn't lie but focussed on the appetite stimulant aspect. My Father gained some weight and strength back, though never back up to his starting weight. Eventually he wouldn't take the meds since they made him feel weird, not in control of his thoughts, a bit foggy and fuzzy but it was a big help to kick-start the eating. We couldn't believe he lived so long after the hard battle and he nearly gave up but I think those anti-depressants were the magic pills for him!
Good luck. It's so hard to watch anyone you love go through this but it's so hard when it's your parent.
Best wishes,
E.

You have some excellent responses. Your father is sick, and it is natural for him to lose his appetite. I agree with those who suggested depression also. I agree with not encouraging the feeding tube. When prognosis' become less positive, feeding tubes prolong suffering. I would try supplements like Ensure and try some different ones to see what he likes, if any. Boost is really popular in the nursing home where I work. Please ask him if he is having a difficulty swallowing. Since he has had esophageal cancer and radiation, it could be possible he is having actual physical trouble swallowing. This can be evaluated by a speech pathologist. Radiation also causes a soreness and acidic foods can feel like they are "burning" when going down. You can also try to make him his favorite meals and see if you can spark some interest. I have seen some success with the appetite stimulant Megace. I am so sorry that you and your family are going through this. My father is currently on the heart transplant list here in Pittsburgh. It is such a struggle to see our parents not well. Hang in there.

Hi, H.:

It is so difficult to allow someone to die.
Give water and maybe so ice popsicles to wet his
lips and allow the man peace in his final hours.

His dying can be such a holy experience if there is
a quiet acceptance of how nature takes it's course.

Peace be unto you and yours.
D.

I am so sorry to hear about your dad though I honestly don't think it's anorexia. With esophageal cancer it may be hard for him to eat. Hopefully this will get better. Have read in the answers where people are recommending anti-depressents. I honestly think they may help. Right now your dad needs you and your mom's support no matter what he decides to do about eating. My dad had lung cancer and wasn't too into eating either. My BIL had cancer and wasn't able to eat more than a teaspoon of food at a time. Your dad will be in my thoughts.

One more thing to consider... a few family members with cancer have told me that the chemo REALLY affects their sense of taste. Things that they used to love may have no flavor at all to them, while other flavors that used to subtle dominate a dish. Often, they are eating because they know they need the nourishment rather than because they find any enjoyment at all in the meal. While this is obviously not the only thing thats impacting your dad's choices, it may well be a major factor that the rest of us don't even realize... he may request something, only to find out that it just doesn't taste like he remembers (perhaps he doesn't want to hurt your mom's feelings or to be a compainer or even to try to explain something that he doesn't understand), so it may take a LOT of trial and error to find foods that he still enjoys... I'm sorry for your pain, but I hope this helps...