Gastro diet questions

@catmomma, hello.

I do have a medical background, certain research skills and writing skills and a fairly good grounding regarding diabetic diets, so until gastroparesis came along to complicate everything, I was able to design a workable kidney-friendly, diabetic-friendly diet. But gastroparesis and inadequate nutrition have complicated things.

I'm not trying to be gluten-free but do avoid gluten foods whenever I can. (As a someone with renal disease on an ovovegetarian renal diet modified to conform as much as possible to a diabetic diet and a gastroparesis diet, I do eat soft white slider buns daily, mostly for the protein content since I cannot eat meat.)

My nephrologist suggested a vegetarian diet several years ago and I made that transition fairly easily. Unfortunately local dietitians were "behind the times" about kidney diets, especially meat free ones, so as I've indicated in other posts, I had to research and design my own renal diet and was able to improve my kidney status as a result, with a few ups & downs, including short-term dialysis now no longer needed - I'm now back to stage 4. (My nephrologists and PCP still offer their patients my recipes with my caveat that since manufacturers do change ingredients and since nutrition content labels also change it's always good to read every label every time a food is purchased.)

I'm also a type 2 diabetic and there is conflict between a diabetic diet and a renal diet. For instance, a diabetic diet encourages consumption of whole grains whereas a renal diet does not due to the extra potassium and phosphorus contents of whole grain foods. (Forget about whole grains on a gastro diet!)

Therefore, as someone with gastroparesis, that diet really conflicts with the other two.

And as I've said before, local GI people here also have been unhelpful, partly because they seem to know little about the other two diets and their food suggestions for gastro would put my only remaining partial kidney at risk as well as make my diabetes management next to impossible.

Hence my restrictive diet to try to manage three chronic illnesses. Lack of adequate dentition restricts me even further.

As for Mayo, this is as close as I can get. I no longer am able to travel and Mayo's wouldn't take my insurance even if I could travel and could afford to get there. I am so grateful for these support groups and for extremely knowledgeable nephs and PCP.

I used to be a gourmet cook and truly enjoyed food (too much!) I used to say I never met a food I didn't like. Gastroparesis has taken the joy out of eating and since I am so mobility impaired (also have Parkinsonian tremors,) I no longer can cook much or continue to experiment with recipes. Having spent a year in and out of the ER and in and out of the hospital and gagging if I even attempted to swallow anything, being able to drink juice and Boost and consume purees and soft foods is an improvement for me. In short, I have felt so awful until recently that eating was a traumatic experience!

Things have improved, though. I do enjoy mashed potatoes, soft avocados, very well-cooked carrots, spinach, beets, and cauliflower and have yet to grow tired of vegetable juice and certain fruit juices.

Any suggestions you might have will be most appreciated so I can continue to improve my nutrition status. Thanks in advance!

I'm sorry about the issues you're facing. Insurances can be a "challenge" (to substitute a phrase I won't repeat here). And thank you for the clarification.

You cooking skills will come in handy-the gastropresis diet can be very unsatisfying to put it mildly. I often supplement with Ensure or Boost, and get creative with those as well. But I don't have the restrictions you do with the renal diet. But I will add to them some orange juice or ice cream to increase fluids, calories, etc. You could try some low-carb ice cream and there are dairy free ice creams as well.

Some thoughts:

I find that fermented dairy allows me to tolerate it better-so Greek yogurt is often a go-to for me, and I can put some cereal on it for texture and consistency.

I don't know if you're supplementing with a probiotic, but that was a game-changer for me. Right now, I have doubled my probiotic as I am having issues with post-COVID GI issues. That is one I think should be required for the GI stuff. This may help:
https://health.clevelandclinic.org/how-to-pick-the-best-probiotic-for-you/
I usually will graze unless I am working. So sips of fluids and a bit here and there as you can get it in. I always have a water bottle or cup at the desk at work and next to me at home. You can go to broths and soups if you need to when things are bad. Fluids is big with gastroparesis because I find if I am dehydrated, the nausea is always worse. I stay away from a lot of fruit juices as the sugar content causes diarrhea.

There are herbal supplements such as Iberogast which was recommended to me at one point by GI (at Mayo). You can ask your doctor about that.

It is also helpful to have some kitchen equipment-for me, a Magic Bullet for smoothies and a food processor for mincing vegetables as I am able to tolerate them. There are books that offer recipes for the gastroparesis diet
https://www.amazon.com/GASTROPARESIS-COOKBOOK-Manuscripts-Gastroparesis-enjoyable/dp/B09NGYCCFK/ref=tmm_pap_swatch_0?_encoding=UTF8&qid=1673737925&sr=8-3-spons
https://www.amazon.com/Gastroparesis-Healing-Cookbook-Easy-Digest/dp/B0B4KCXB2G/ref=sr_1_11?crid=2UT4K7PQBGQ27&keywords=gastroparesis+cookbook&qid=1673737925&sprefix=gastroparesis+cookbook%2Caps%2C145&sr=8-11
Some of it is trial and error. There are good days and bad days for me. And sometimes I cheat. But I usually pay for it ;-).

You can message me on Connect if you wish.

@catmomma, thank you so much for your thoughtful reply and the links.

I used to cook a lot but can't do much any more. Tremors make it too dangerous to cook and chronic fatigue makes cooking even more challenging. (LOL, like you, I can think of another word but like you I won't use it here.) An area non-profit senior agency sends in a worker twice a week to do dishes, dust, sweep, clean bathroom and kitchen and prepare certain things for meals for two or three days. So, in general, if it can't be microwaved or eaten cold it doesn't go on my plate.

I do eat non-dairy yogurt with probiotics twice a week but only a half serving each time because of the fat content in the coconut milk in it. And there are some excellent vegan frozen dessert "ice creams" available. Here again, though, I only eat this occasionally and then usually less than a full serving due to the fat content but it's enough to satisfy me.

I totally agree, fluids are a must. I try to get in 60 or more ounces of water, juice and Boost every day.

I do have a blender but no longer can physically deal with it, partly because of my wheelchair height but mostly because of my shakiness so my worker uses it to puree some of the veggies she cooks for me. I will check into the Magic Bullet, though - maybe I could use it. Thanks for the idea.

You said something that really caught my attention when you mentioned grazing. Everything I've read so far has said not to graze but if I could do that, I would be much more comfortable than I currently am with 3 small meals a day and 3 smaller ones.

My neph & internist and PCP okayed ginger capsules to control nausea since Rx meds for that usually only work short term and it has helped a lot.

I agree, broths and soups are good to "go to" when I can't tolerate purees and soft solids.

And I hear ya about paying for it when you cheat, LOL. Like you, I usually regret it.

Thanks again for your help, hope we can keep in touch!

@annabelle1245, thanks for the input and the info.

Yesterday evening I tried just a tsp of prepared mustard and so far so good but time will tell.

Good idea about using my m & p to grind the celery seed, although I think I should wait awhile before trying celery seed and first see how I tolerate small amounts of the mustard. Am not sure I could eat actual de-stringed celery due to lack of proper dentition but it's great that you can tolerate it. :=)

The guac is a great idea, too, except I usually just put very ripe/very soft avo in a sandwich for lunch.

I, too, like veggie burgers but have had to steer clear of most of them since I try to limit soy but I do ok with "chikn" nuggets as long as I only eat 2 instead of the recommended serving amount of 4 or more.

I eat 5 or 6 small meals a day and even though it's less convenient than the so-called three squares, it works for me. At the height of my first two flares, I lost 70 pounds but have stabilized after a year marked by pure misery.

I guess baby steps and caution are the keys.

Thanks again. Hope we can share ideas in the future.

@catmomma, thank you so much for your thoughtful reply and the links.

I used to cook a lot but can't do much any more. Tremors make it too dangerous to cook and chronic fatigue makes cooking even more challenging. (LOL, like you, I can think of another word but like you I won't use it here.) An area non-profit senior agency sends in a worker twice a week to do dishes, dust, sweep, clean bathroom and kitchen and prepare certain things for meals for two or three days. So, in general, if it can't be microwaved or eaten cold it doesn't go on my plate.

I do eat non-dairy yogurt with probiotics twice a week but only a half serving each time because of the fat content in the coconut milk in it. And there are some excellent vegan frozen dessert "ice creams" available. Here again, though, I only eat this occasionally and then usually less than a full serving due to the fat content but it's enough to satisfy me.

I totally agree, fluids are a must. I try to get in 60 or more ounces of water, juice and Boost every day.

I do have a blender but no longer can physically deal with it, partly because of my wheelchair height but mostly because of my shakiness so my worker uses it to puree some of the veggies she cooks for me. I will check into the Magic Bullet, though - maybe I could use it. Thanks for the idea.

You said something that really caught my attention when you mentioned grazing. Everything I've read so far has said not to graze but if I could do that, I would be much more comfortable than I currently am with 3 small meals a day and 3 smaller ones.

My neph & internist and PCP okayed ginger capsules to control nausea since Rx meds for that usually only work short term and it has helped a lot.

I agree, broths and soups are good to "go to" when I can't tolerate purees and soft solids.

And I hear ya about paying for it when you cheat, LOL. Like you, I usually regret it.

Thanks again for your help, hope we can keep in touch!

By the way, my own opinion is everyone should be on a daily probiotic. Sorry if I wasn't more specific.

And last time I had pizza, I suffered for three days.

Eating ice cream is not good for someone with CKD. Very high in potassium, bad for kidneys.