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Can Poor Intake Of Solid Foods Lead To Malaise?
Question: My normal resting pulse rate is typically between 75 and 80. I am a 74 year old male in my sixth week of post chemo and radiation treatment for cancer of the tongue. Lately, my resting heart rate is in the 90s and if I walk from one point in the house to another, it exceeds 100. Feel very weak most of the time, yet this is a somewhat new phenomena that I haven't experienced consistently during the first five weeks. It now seems like this is the new norm and is not indicative of my making progress in recovery. I am fed protein supplements through a feeding tube. Could the lack of solid foods be a cause of this new malaise?
Brief Answer:
Electrolyte imbalances might affect energy and some other possible causes and advises given
Detailed Answer:
Hello,
Feeding through a tube can be a great help after the surgery you have had. It is thought that using prescribed food addresses the patients needs for different nutritious ingredients better than using natural food (blended solid food), so it is good you are using protein supplements prescribed by your doctor.
On the other hand, tube feeding can have its own side effects. fatigue can happen in tube feeding patients for several reasons:
- the electrolyte imbalances: as it is happening in your case the potassium being low can affect your energy levels so it is important to take more potassium to balance it.
- stress ulcers in the stomach are higher in patients with tube feeding so if you are noticing any blood coming out with the tube or if you have dark stools (black dark stools) while you do not take iron supplements than an ulcer should be suspected and the right tests should be done to rule it out.
- the basic disease and the surgery itself increase the risks for anemia in your case so it is important to have a CBC to check for anemia. One of the signs of anemia is fatigue and the pulse might go high because the heart is trying to make up for the reduced blood capacity to transport the needed ingredients.
Another risk with feeding tubes is the risk of aspiration (even with stomach tubes)- meaning the risk for pneumonia due to ingredients passing through the air tubes. In this case, you might get cough, fever and fatigue. If you are having cough and or fever you will need to be checked by your doctor to rule out pneumonia. Your doctor might do a chest x-ray and ECG if he finds it needed.
To conclude I would say:
- please make sure you have a CBC done to rule out anemia and iron shortage
- if you have dark stools or even small amount of blood with the tube consider an ulcer and you need to be investigated to rule it out
- potassium is a major possible cause of fatigue in your case so it is important to make sure you increase the intake of it (if you are using food that your doctor is prescribing you might need to talk with him so you may have some increase of potassium in the food you take)
- if cough or fever is present please be checked to rule out pneumonia
- trying to be gradually active will help- this means you try to do little efforts frequently during the time. Staying in bed for prolonged times will make you feel tired and will not help your physical performance. Standing and walking small amounts (as much as your body allows you) and doing this several times a day will help you be stronger. You might notice that while days go by you might feel more energetic and do more. This should be done after you have ruled out iron shortage.
- if you are smoking please make sure you quit as smoking affects the lungs oxygenation and makes you feel more tired.
I wish you quick improvement and hope I have been a help to you but please feel free to reply if more clarification is needed on this.
Regards,
Dr. Zotaj Antoneta, General & Family Physician
Electrolyte imbalances might affect energy and some other possible causes and advises given
Detailed Answer:
Hello,
Feeding through a tube can be a great help after the surgery you have had. It is thought that using prescribed food addresses the patients needs for different nutritious ingredients better than using natural food (blended solid food), so it is good you are using protein supplements prescribed by your doctor.
On the other hand, tube feeding can have its own side effects. fatigue can happen in tube feeding patients for several reasons:
- the electrolyte imbalances: as it is happening in your case the potassium being low can affect your energy levels so it is important to take more potassium to balance it.
- stress ulcers in the stomach are higher in patients with tube feeding so if you are noticing any blood coming out with the tube or if you have dark stools (black dark stools) while you do not take iron supplements than an ulcer should be suspected and the right tests should be done to rule it out.
- the basic disease and the surgery itself increase the risks for anemia in your case so it is important to have a CBC to check for anemia. One of the signs of anemia is fatigue and the pulse might go high because the heart is trying to make up for the reduced blood capacity to transport the needed ingredients.
Another risk with feeding tubes is the risk of aspiration (even with stomach tubes)- meaning the risk for pneumonia due to ingredients passing through the air tubes. In this case, you might get cough, fever and fatigue. If you are having cough and or fever you will need to be checked by your doctor to rule out pneumonia. Your doctor might do a chest x-ray and ECG if he finds it needed.
To conclude I would say:
- please make sure you have a CBC done to rule out anemia and iron shortage
- if you have dark stools or even small amount of blood with the tube consider an ulcer and you need to be investigated to rule it out
- potassium is a major possible cause of fatigue in your case so it is important to make sure you increase the intake of it (if you are using food that your doctor is prescribing you might need to talk with him so you may have some increase of potassium in the food you take)
- if cough or fever is present please be checked to rule out pneumonia
- trying to be gradually active will help- this means you try to do little efforts frequently during the time. Staying in bed for prolonged times will make you feel tired and will not help your physical performance. Standing and walking small amounts (as much as your body allows you) and doing this several times a day will help you be stronger. You might notice that while days go by you might feel more energetic and do more. This should be done after you have ruled out iron shortage.
- if you are smoking please make sure you quit as smoking affects the lungs oxygenation and makes you feel more tired.
I wish you quick improvement and hope I have been a help to you but please feel free to reply if more clarification is needed on this.
Regards,
Dr. Zotaj Antoneta, General & Family Physician
Above answer was peer-reviewed by :
Dr. Prasad
Dr. Antoneta:
Just so you know, I had a CBC done and my hemoglobin levels are lower than normal, but not quite low enough for a blood transfusion. But the CBC alone did not contain enough information for my oncologist to determine what treatment to prescribe. He had his lab people take a full chemistry panel to see what specific levels I may be low on, such as potassium or chloride in order to supplement as needed. My anemia is a result of the chemo and radiation and typically comes and goes for about eight weeks post treatment. I am in my sixth week of recovery, so it is nothing unusual and ultimately time will be the cure. Taking an iron supplement will do no good in my situation. Also, my chest x-ray showed the lungs were working perfectly. Thank you for your response. It spurred me into action and I'm feeling a little better today than when I first wrote to you. XXXXXXX XXXX ( YYYY@YYYY )
Just so you know, I had a CBC done and my hemoglobin levels are lower than normal, but not quite low enough for a blood transfusion. But the CBC alone did not contain enough information for my oncologist to determine what treatment to prescribe. He had his lab people take a full chemistry panel to see what specific levels I may be low on, such as potassium or chloride in order to supplement as needed. My anemia is a result of the chemo and radiation and typically comes and goes for about eight weeks post treatment. I am in my sixth week of recovery, so it is nothing unusual and ultimately time will be the cure. Taking an iron supplement will do no good in my situation. Also, my chest x-ray showed the lungs were working perfectly. Thank you for your response. It spurred me into action and I'm feeling a little better today than when I first wrote to you. XXXXXXX XXXX ( YYYY@YYYY )
Brief Answer:
I am happy you are better and that the examinations do not show anything worrisome
Detailed Answer:
Hello,
It is great you are feeling better. Chemotherapy is heavy on the patients and can be a major cause of fatigue and might also change the CBC. I am glad that the CBC is not all that altered to need transfusion and that also iron seems to not be needed at the moment.
Now that you had your check and is confirmed that the tests are well, all you need is to rest well and true it is the time the major improvements.
Hope I have answered your query.
Regards,
Dr. Zotaj Antoneta, General & Family Physician
I am happy you are better and that the examinations do not show anything worrisome
Detailed Answer:
Hello,
It is great you are feeling better. Chemotherapy is heavy on the patients and can be a major cause of fatigue and might also change the CBC. I am glad that the CBC is not all that altered to need transfusion and that also iron seems to not be needed at the moment.
Now that you had your check and is confirmed that the tests are well, all you need is to rest well and true it is the time the major improvements.
Hope I have answered your query.
Regards,
Dr. Zotaj Antoneta, General & Family Physician
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Above answer was peer-reviewed by :
Dr. Remy Koshy
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