I have not been able to eat much since the surgery – in addition to the hiatal hernia I was born with, it feels as if the residual CO2 has filled every possible space in my abdominal area, and I have felt uncomfortably full all the time since Thursday. But I also know that I have to eat something, just a little even, so on Monday my dear friend C accompanied me on a little shopping trip to Whole Foods.
Making the right dietary choices has been critical to managing this disease from the very start. Because of the insulin resistance (IR) it causes, I am extremely sensitive to carbohydrates; as I often jokingly say, I look at a potato and I gain five pounds. Because sodium exacerbates water retention and increases blood pressure, I avoid restaurants, prepared foods, and any situation in which I can’t know with full certainty that my food has been prepared without any added salt.
Except – now I don’t have to watch sodium. Before I left the hospital, my surgeon told me not to worry about that any more. In fact, some doctors actually encourage patients to eat high sodium at all meals for a short time post-adrenalectomy, in order to get the remaining adrenal to “wake up.”
As for insulin resistance, some studies, such as this one, posit that IR in PA patients will reverse within 6 months of treatment, whether surgical or medical. This is a little less cut-and-dried than the sodium bit; no one can really advise me as to when/if I can be more lenient about carbohydrates.
So, it’s back to a routine I’m already all to familiar with: my body, my science experiment.
I’ve already lost seven pounds since the surgery, so I’m not all that worried about weight gain (and its undesired dangerous side effects of increased fasting blood sugar and elevated BP) in the short term. In addition, when I’m not feeling 100%, my favorite food to eat is rice. So, I’m allowing that. In addition, since my digestive system seems to have gone to sleep, I’m giving myself a rest from all animal proteins for the time being – no chicken, no fish, no eggs until I feel a little more normal. Nothing against these foods; they just feel a little heavy for me at the moment.
My first day out of surgery, my total food intake was a half-cup of basmati rice. The next day, a half avocado. The day after, another half avocado. Which brings me to Monday, my day of shopping.
I began my day with 1/4 cup of plain, whole-milk Greek yogurt. Around noon I actually started craving “real” food for the first time since the surgery – specifically, Indian food. I pondered this a bit and while it was definitely curry that was on my mind, it was also salt that I was craving. So, when we got to Whole Foods, I decided to do something I rarely do – check out the prepared food offerings. And when I saw Curry Garbanzo Tofu soup, I got brave and took home a small container. More a stew than a soup, it went over a bit of jasmine rice and was absolutely the most delicious thing I had tasted in many months.
I half expected my usual symptoms from sodium intake to come on overnight – headache, irregular heartbeat, weight gain. I also expected to feel like I was going to crash from the carb intake within 40 minutes of eating, even though I only had a small portion. But – nothing. In fact, I was down another pound in the morning.
Tuesday I had my first post-op follow-up with my nephrologist. I told him what the surgeon had said, to not worry about sodium, and that I felt that it was still unwise. I also told him what I had done, to no ill effect. His advice was that this was entirely appropriate – don’t go out and eat a bag of potato chips, but don’t stress out about every bite. I can do that.
I’m not entirely certain where all of this will take me – as mentioned before, I have hopes of being able to cut back on the animal protein as much as possible since I hate cooking it and don’t enjoy eating it. If the insulin resistance truly does go away, and Every Single Carbohydrate doesn’t go straight to my belly, perhaps this can be done. I know that my dietary intolerances to lactose, fructose, and gluten are an entirely separate issue and will not likely be influenced by my lack of a bad adrenal; this I don’t mind, as I very strongly believe that sugar and gluten are not “good” for anybody, and would never go back to eating them. So, as I continue to decline your offers of cookies or bread, please don’t take offense.
Right now, I’m just excited at the possibilities that have opened up just knowing that I can eat something that somebody else made. And thrilled at the prospect of Indian and Thai and Japanese food being a part of my life again.