[TanyaRD]

Hi Susan. Rich brings up a good suggestion about appetite stimulation. If you have never been on an appetite stimulant and have struggled with the symptom for a while it could be a good time to try something. We commonly use Megace, Marinol and sometimes Remeron for appetite stimulation. Megace probably works the fastest but cannot be used if you have a history of blood clots (DVTs). Marinol also works for nausea right away but the appetite stimulation can take a couple of weeks. Remeron is an antidepressant starting at the 45mg dose but we will sometimes use a 30mg dose at bedtime for appetite and see decent results.

As far as food goes the goal will be to maximize calories in a volume you are able to tolerate. It is difficult to eat large volumes of food/fluids when you have no desire to eat. I encourage my patients to try eating every 2-3 hours. It doesn't have to be anything big but maybe 4-6 crackers with peanut butter or cheese (low fat if a lot of trouble with fat). Cottage cheese and fruit or other cool foods are often well tolerated because there is no steam (or smell) coming off the food. Sometimes liquids are better tolerated too. Of course oral supplements are another option. I have recently been using a product called Unjury (unjury.com). They offer whey protein based protein supplements and one of them is chicken soup flavored which is actually very palatable.

If there is a Registered Dietitian available at your clinic it can be advantageous to meet and develop the best plan for your needs.