Monday, April 18, 2011

The Hunger Mindgames

I don't experience hunger any more. I think hunger is a sensation produced solely through communication between the stomach and the brain. So no stomach, no hunger. Period. Now if too much time elapses between meals, then I do get a feeling that "I have to eat" but I think this is more a sense that my blood chemistry is becoming imbalanced.

What used to be a funny organ at the bottom of the esophagus saying, "Hey, fill me up!" has become more the feeling of some metabolic function letting me know it's getting kinda bored and needs something to do.

My niece, also a gastrectomy patient, says she does get hungry. But I'm willing to bet this feeling she has isn't true hunger at all. I think people experience similar sensations and interpret them differently.

This could provide a valuable lesson to researchers. Emotional eating is real. When I want to eat something, I'm having a craving, I know that my body doesn't physiologically need it, it isn't real hunger. But I could interpret it as hunger and I would feel compelled to satisfy what I believe is a need. Without a stomach, I can tell the difference. Most people cannot. This leads to overeating and weight gain.

Recently, I flipped through a cooking magazine. One of the articles featured paninis, and had several recipes accompanied by tantalizing photographs. Just the visual stimulus of those pictures alone caused me to want some kind of hot sandwich with meat, sautéed vegetables, an excessive amount of cheese and some kind of sauce or herbal seasoning blend.

Now, this feeling created in my mind is a sensation I would have previously interpreted as hunger and I would have done something to get a sandwich like that, pronto! Even now, just thinking about it while writing this, I'm getting that feeling. I can even feel in my abdomen, a faint gnawing pinch; something that could be hunger, but I know isn't. My brain is just telling me that it is, because it wants an emotional need created by the magazine pictures satisfied.

I know I'm not "hungry" because I'm in the middle of slurping down a 12 ounce smoothie, which is about four ounces more than I usually have. So I know for a fact that my body doesn't need a panini right now, my mind just wants one. And if I were physiologically able to eat a panini right now without becoming ill, I would probably do it. But I know better. Now I can tell the difference.

Another mental aspect of eating that has changed is what I find appealing. I haven't had any kind of fast food since my surgery. Nor do I have any kind of cravings for it, ever. French fries make me gag, as does pretty much anything cooked in a fryer. That greasy, crispy cuisine hailed by some (hungover people) and cursed by others (health-conscious people) makes me ill just thinking about it.

On occasion, I've been able to have Chick-Fil-A, but not the sandwiches, the rolls not work well for me, just a few chicken strips and maybe a waffle fry or two. I actually tried a fast food burger the other day with disastrous results. So I won't be doing that again anytime soon. Pizza continues to be a problem and is even becoming less and less appealing.

Processed food, some would argue it isn't even food anymore, doesn't work very well for me. And it's not to say that prior to my surgery I ate a lot of it, probably less than the average person. But now that kind of food, laden with corn syrup, sodium and processed oils, is so easy to avoid.

The downside of not being able to eat convenience foods, is that if I'm unable to fix myself something, I'm often not eating anything. Thanks to liquid nutrition on those days. It tastes terrible, but at at least provides some needed sustenance.

Signing out now, I have to go eat something. I'm not hungry, remember, I just have to eat!

Friday, April 8, 2011

Just a Bundle of Nerves

I was amused to a while back to see on The Colbert Report, a reference to the "gut brain." It reminded me of reading the blog of another gastrectomy patient last year:

"So why don’t I feel normal? I know it’s still early, but I thought that once I started doing normal things – eating, working, going out – that I would feel like I was getting into my routine, into my life, back to normal.  But I don’t, I feel uncomfortable and unsettled.  I have been working so hard to get my body readjusted and healthy again, I wonder if emotionally I’m just way far behind.  Some of it I know is thinking about Dad and starting to cope, in earnest, with losing him.  But it’s more than that – I know I didn’t have brain surgery, but I honestly feel (and this sounds ridiculous in my head as I am typing) – I feel like a part of my personality was in my stomach.  And that part got cut out too, and now I don’t feel like me.  I’m different, it’s different, everything has changed. And boy I wish the pathologist could find whatever I lost on one of his slides, but I don’t think it’s quite that easy." -Brian Chelcun (http://www.caringbridge.org/visit/bchelcun)


I had similar feelings very soon after surgery. It's hard to explain, but simply a sense of something being missing, on an emotional level, not just the very real physical aspect of a major organ being gone. Having this surgery can also have some benefits aside from the getting-rid-of-cancer-thing. Just prior to surgery I collected all my doubts, fears, bad habits and general negativity and I metaphorically swallowed them. The idea was they would be in my stomach when it got cut out, ergo, all that bad stuff would go with it. It seemed to work for a while, but somehow some of it has crept back into my psyche. Maybe it all got stuck in the esophagus or was fully reabsorbed before the stomach got cut out. I dunno.

I had read that having a gastrectomy can effect mood, and not just in the obvious way that adapting to life without a stomach can trigger a bit of, say, melancholy. It seems this enteric nervous system can play a role in emotions. It is, after all, a very real part of the nervous system. And it's the science behind such notions as a "gut instinct," and "butterflies in the stomach."

(some sauce for those interested):

http://www.nytimes.com/2005/08/23/health/23gut.html?pagewanted=all

http://www.scholarpedia.org/article/Enteric_nervous_system

http://www.psyking.net/id36.htm

In any case, I think this all speaks to the whole mind-body connection. Alternative approaches to health speak of the subtle bodies. The theory is that there are very real "bodies" connected to our physical one and that imbalances in those bodies can manifest themselves in our physical health. It's said that is how certain inexplicable healing can happen and explains how sheer will seems to make a person stronger, healthier and sometimes able to defy all scientifically medical odds. To me the enteric nervous system represents a real physical aspect of some of this stuff.

Science tells us that stress can adversely affect the body. The evidence shows that a heightened mental state will raise the blood sugar, trigger hormones that will alter metabolic functions. But it fails to tell us why; and is only beginning to figure out that a person simply using the mind can lower stress levels, thereby decreasing any associated risks.

If one can lower their own blood pressure simply by focusing on breathing and calming the mind and then the body, is it really that much of a stretch to believe that the same person can't lower their risk for getting a cold by a conscious effort to direct their immune system to attack and neutralize an invading viral infection?

Don't get me wrong, I don't think, by any stretch of the imagination, that a person can meditate away a stage IV cancer or stop the hemorrhaging of a severed artery by visualizing it magically regenerating. I just think that focused will plays a very large role in our overall health and the power of the mind should never be discounted when it comes to the healing of the body.

If the gut brain is associated with the entirety of the gastrointestinal tract, I would think that the stomach would be like it's cerebral cortex. So it's no wonder that without a stomach and the nerves that accompany it, one's second brain can be sent into a tailspin. Unlike the brain in our head though, the body can function without a stomach. It's just a matter of reconnecting the disjoined parts. The physical parts were rejoined as part of surgery, but the mental and emotional aspects seem to take much longer to heal. This is ongoing and just part of the process.