as small as a world and as large as alone

10:46pm June 18, 2014

nicocoer:

andromedalogic:

if you feel like you’re starving, you need to eat.

UNLESS you have Prader-Willi syndrome.

that is the only exception to the rule because in that case your hunger-causing hormones are out of whack.

in general hunger is the ONLY good indicator for how much you should be eating.

As someone with some compulsive stuff, I will say other things can mask as hunger, so (at least for me) figuring out if it’s hunger hunger or my brain being a dick hunger is another step for me.

Which is part of why I have a check list that says veggie/fruit, 2 carbs, and a protein (dairy, meat, or meat substitute) so I can figure out if I’ve eaten and what I’ve eaten, which can help me figure out if I need food (as in, I can’t remember if I’ve eaten and if I’m not that headache is not a headache but an ANGRY CALL FOR FOOD, and if so to move to the tension/hydration/migraine check list, not a it is bad if you go over check list) and if so what food consuming needs my body has yet to get that day.

But that is not a universal thing and yeah.

Sparking of I need to make myself stop with the tumblr sometime soon and eat my sub.

Also if you’re on a feeding tube and steroids, everything gets messed up.

If you get behind on your feedings.  And your feeding tube is one that does a slow feed, so that you get the entire meal over the course of 24 hours, a few milliliters an hour.  Then that means that you’ll be super-super-super-hungry until you catch up.

And if your stomach is paralyzed and the feeding tube is bypassing your stomach into your jejunum, the last thing you want to do when you feel that overwhelming hunger is to eat.  Because the food will back up into your lungs, at best.  I have learned this the hard way (and my pulmonologist is furious with me, she says that by eating in situations like that I’m basically throwing my life away when we did all this to save it, and she has a point).

So what I do, is I put the feeding tube in, and I start the feeding.  Knowing that I won’t feel full for another 12 to 36 hours.  

In the meantime, I chew gum.

Lots of gum.

It does have an effect on my stomach, which I have to drain more often, because my stomach produces more fluid and gas when I chew gum.

But, chewing the gum staves off the urge to eat when I shouldn’t eat.  And by eat I mean chew and swallow food.  Which, without the gum, becomes an urge so overpowering that it’s impossible to resist.

The gum somehow bypasses that and makes me feel as if I’m eating, and then eventually I feel full because my feeding tube food catches up with my actual food intake.

This sort of situation has gotten worse since I’ve gone on steroids, which stimulate the appetite.  One reason I had no appetite all that time was I had severe adrenal insufficiency.  Dexamethasone stimulates the appetite quite a lot, so now chewing gum is a staple in my house.  (I avoid chewing around people with misophonia.  I have misophonia myself.  I know how horrible gum noises are when it’s not yourself making them.)  

I know I get weird looks buying gum with my EBT card, but gum is as essential to my ability to survive as food is essential to most people.  Without gum, I would be eating caramels or something, and those caramels would be causing aspirations, and those would be causing pneumonia, and eventually I’d die, and we don’t want that.  So gum is absolutely an essential staple in my diet, along with the Osmolite that actually provides the nutrients.

Gum isn’t without its own hazards, but I’m careful to drain my stomach continually while chewing and so far I haven’t aspirated any of the excess gas and fluid that happens as a result of chewing all the time.

But I’m another example of a situation where hunger does not necessarily mean you should eat.

I know it’s almost as obscure as Prader-Willi, but it does exist.  And the desire to eat, in this circumstance, is so overwhelming that without gum, I would do anything to get food and eat it.  It makes me realize why diets don’t work:  Past a point, eating is not a voluntary act, it is a reflex, and we will do it once we become too starved.

In my case the point where I become too starved is when I’ve been fasting for a blood test or something, and then there’s this giant lag time where the food isn’t getting into my body, meanwhile the dexamethasone is sending my body signals going “HUNGRY HUNGRY HUNGRY” and I go frantic with desire to eat something, anything, no matter how ridiculous and impossible the thing might be.  And then I either find some gum and chew it (best outcome), or I eat something and risk aspirating (worst outcome – and about half the time I eat something I do aspirate later, even when “eating something” consists of eating a couple caramels that melt in my mouth…then go into my stomach and churn up all the stomach fluids and gases that then jump up into my lungs and go partying there).

So yeah in most instances, if you’re hungry, eat.  But in medical situations like this, there may be good reason to be really careful.  I am chewing gum right now and I am thrilled that it stops my urge to eat things.

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