Expert: Leigh-Anne Persing, PA-C - 11/3/2008

Question
Dear Leigh-Anne,
I am on my 34th day in recovery ! Am 39 years old and at weight 38kg a month ago. Am eating 1200 a day but now upped it to 1400 yesterday. Have no idea what calorie intake I should be on so am guessing it as no doubt have a very low metabolic rate. I work, look after two children and fight to get in high fat/protein meals 3 times a day and snacks in beteeen. I am drinking water as much as I can as I was terribly dehydrated. In terms of timings is a logisitcal nightmare - take enzymes 20 mins before food to help GI tract work. Take water 30 mins first and then wait two hours for more water. Limit coffee, etc etc, get in calories. Whoa- what a complete nightmare, starving was hell but this is harder I must say.
I wanted to ask two things: I still have awful side effects at night from eating my final meal of the day - dizzy, nausea, heart racing, headache, very sleepy. I think it is hypotension but not sure. What do you think - i have cut sown on protein size and also on carbs and I load the calories in with fats - oil, butter, marscapone, cream.. to get the most in with the minimum amount of substance.
Secondly, not really sure whether to have alot of water or not, do have swollen lower legs by night time around my socks.
Of course, no food moves through my stomach and intestines so I help it along with enzymes and aslo the odd enema every two dasy just to help with the bloating etc. Oh boy - fun huh!
I can't manage many carbs, I certainly could not manage Ensure or sweets or cake, it sends me very unwell and faint. I have not had any sugar for abgout 3 years so, I guess that is why...
any adive at all re: appropriate caloies and water leels. I have only weighed once as I hate the whole scale obsession and I realised what I have always suspected. TYhe scales are a waste of time, they change daily by 1kg, up down, up down depending I assume on current wqater retention and bowel movements. I am trying to follow teh Maudsley approach and parenting myself and so am increasing caloiures very slowly. Anyway, is impossible to go quicker as have such horrendous after meal experiences.

Thanks for any help and advice...


Answer
Water retention during recover is a VERY common problem and will resolve on it's own over time. Don't try to limit fluids because you think it's going to help with the swelling. Fluid pushes fluid. the more you drink the mor you pee off!

Congratson tryingt o get in the calories, but I think you need to make smarter food choices. Loading foods with oils, margarine, cream, etc. is not the way to go. You can make healthier choices such as granola, granola bars,, meats, eggs, that can give you the appropriate fats and proteins. You still need to get some carbs as they provide glucose. You may have some component of hypotension, but you may also have some low blood sugar too if you aren't getting enough carbohydrates.