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Hi,


I haven't posted here, I've read quite a bit. I just came here originally to get insights on how older adults were doing overall, as I sometimes did work (fitness) in assisted living facilities and adult day centers. But now, I find myself in a difficult place with my family, and I am hoping someone might be able to help.


My brother is young, only 50 something, but a heavy smoker, and he had a heart attack November 2020. He went on disability and had a year to quit smoking, but he didn't quit. Almost exactly a year later, he had kidney failure (Christmas 2021)


He began dialysis, and does okay with that, but he began losing so much weight. He had so much trouble with the restrictive diet, and honestly, he was only used to eating Mcdonald's or whatever from 7-11.


It is only March, and he is under 100 pounds. He lives far away, and I flew out to see him. It's breaking my heart. He has been in and out of hospitals. They release him, and he just struggles until his next dialysis.


So anyways, now he is back in the hospital, but the problem now is he won't eat. The other times he was eating at least, and he would get a little better, but once he is out on his own, trouble.


The good news is, they won't release him again, they are going to place him somewhere. But if he doesn't eat, that's it, right?


My question is about the eating. Why can't he tolerate any food? Does anyone have any ideas or experience? Why is it so little the body can take in for liquids on dialysis? It doesn't make sense to me--the body needs water. He is just wasting away. He isn't smoking and that is ironic. He can't smoke.


I had no idea where to put this question, I chose diet/nutrition.


MB

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Welcome, Fit.

The question in my mind is can't eat or won't eat?

What investigations have been done? Has he had a swallowing eval by a speech/language pathologist? Been examined by a psychiatrist? Has a nutritionist weighed in? Does he have prior mental health issues?

A little more information will get you better answers.
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I am on dialysis. I have fluid restrictions and diet restrictions. Dialysis is made less effective and more difficult if you don't follow the strict fluid restrictions. I am sure the food problem is that he is used to eating junk food and is not that he is unable to tolerate food. He needs to work with a nutritionist and change his eating habits. I am also diabetic so my diet is even more strict. It takes self-discipline which is not always easy. But I've conditioned myself to resist all of the temptations. I allow myself a treat once a month - nothing big and nothing drastic. I want to live and there are not any options available.
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afitclass Mar 2022
Thank you very much- I am sure what you are going through is very difficult, it sounds like you are giving it your all.
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I came here to say what Becky said. Studies have been done on mice where they were fed only a diet of junk food; then the junk food was removed and they were only given healthy foods instead. They ALL starved rather than eat the healthy foods. True story. The brain gets wired (literally) to eat only junk foods which are purposely formulated with certain ratios of fat/salt & chemicals that cause the brain to react by releasing serotonin and dopamine, much the same way as happens with cocaine & other addictive drugs.

Your brother is likely refusing to eat rather than not being 'able' to eat b/c he has no tolerance for healthy foods; only for McDonalds and other processed foods which have been his staple for so long, and which have wrecked his health. Sad but true. Maybe if he feels very hungry, he'll try some foods that he'll find tolerable to eat; maybe some with a sweeter taste like applesauce or fruits. That may happen, it's possible. But yes, if he doesn't eat, his body will go into ketosis where it burns fat for fuel till it's all gone, then it reverts to burning muscle which is a serious issue that can cause his death.

I'm really sorry you're both going thru such an awful situation. May God help you both and bring peace to you as you travel this path.
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afitclass Mar 2022
Thank you, very much, that is very helpful and a useful insight. I will discuss that with my dad, and my brother’s team.
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He's on dialysis because his kidneys aren't functioning. Dialysis is removing the fluid and wastes from his body. The fluid restrictions keeps his dialysis working properly.
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Hi Friends,

I am just following up on this post I had made.

Sadly, my brother passed away on March 31st. Fortunately I was able to be with him for the last 4 days of his life.

It might help someone to know that the last hospital he was at looked into his stomach and found that he had had an ulcer. They began giving him medication for it, but of course it was too late.

If someone is not eating, or can't keep food down, have the medical facility check for ulcers. Not that it could have saved my brother's life- what would have saved my brother's life was the bypass surgery when the heart attack occured, despite the dangers. But hindsight is hindsight.

Thank you all for you caring answers. I feel blessed to have had a brother this long who smoked so much, honestly. I am dedicating my work to him, as a Zumba instructor (I believe it was my love for this activity that got ME to quit smoking, and saved my own life)

And I'm also grateful to the hospital (Kaiser) who took amazing care for him, and helped me in the last 4 days with emotional support. ( I will be offering them seated classes for their patients, I feel so much love for this facility. Good things come out of everything)

Best to all of you on dialysis, and with families going through such struggles, I hope for you recovery, wellness, and happiness. I learned quite a bit these past 4 months.

Monica B.
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Isthisrealyreal Apr 2022
Monica, I am so sorry for your loss.

May The Lord give your family grieving mercies, strength and comfort during this new season.

What a wonderful gift you are offering in memory of your brother and his care team.
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I'm sorry for your loss. At least you know what was contributing to his appetite loss. That said....

My husband had three Stage IV cancers, one was renal cell carcinoma (not that the kidney cancer only relates to this), but as the body shuts down, it doesn't want liquid or food. It can actually increase discomfort/pain.

The best we can do for ourselves after a loss is to help others, which you are doing. Best wishes as you move forward. Stay strong. My thoughts are with you.
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afitclass Apr 2022
I'm so sorry. It is a very difficult thing to watch.

Yes, my students are very supportive and comforting to me- and extending help to others feels right as well

Best,
Monica B
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End-stage renal failure patients who don't eat, develop electrolyte imbalance that can cause sudden death.
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Hi

I'm so sorry for the loss of your brother.
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