Wife serious injury and not eating

[Worriedhubby123]

Hi all

I’m not a mum, but hoping you mums can give some advice?

my wife had a car accident 3 weeks ago and has 2 compression fractures in her spine as well as whiplash. Was in hospital for a night but now home (she has a spinal brace but didn’t need surgery) and in a lot of pain and on large amounts of pain medication. (If it matters Co-codamol, gabapentin, diazepam, naproxen, omazeprole and tramadol on a rotating schedule.) she also is taking vitamin supplements.

obviously heavily encouraging her to do as little as possible other than her physio exercises and she’s signed off work for 12 weeks. We have a child but he is not tiny (year 5) , and I do laundry etc and have a cleaner that comes in 2x a week to encourage her to rest as much as possible.

The problem is she’s not eating. I will make breakfast for me, her and our son before leaving for work/taking him to school and I notice when I return it’s not been eaten. Her mum made her loads of frozen ready to eat microwave meals which remain untouched, and I keep loads of her favourite snacks beside her which she doesn’t really seem interested in. We have dinner together but she will pick at it and usually only be able to eat 1/3 of a portion.

I’ve voiced my concerns and she says that the medications are making her very tired and she has completely lost her appetite. She’s visibly losing weight rapidly and I’m concerned, but don’t really know if I should be nagging her about this or will it just pass in time? I’m also worried that the strong meds will be doing damage if she’s not eating enough.

would appreciate advice from anyone who has been through a serious injury like this?
Thank you

@Worriedhubby123

Have you asked your GP for a home visit?

No - she insists she’s fine and recovering normally and doesn’t need a GP.

You sound like a caring and supportive husband.
I do think it’s time now to get a GP to do a home visit.

I don’t want to go behind her back to do this - I feel it would be a huge betrayal of trust for her. I don’t even know if I can if she doesn’t consent to this? Any ideas? I will phone the GP tomorrow and ask for advice though.

Can you get her to drink fortisip, I think it's called? She is probably feeling quite stoned and woozy on those meds. You're right to be concerned - she needs nutrients.

Just ordered some from Amazon! They look great and it’s another option at least.

Does your surgery offer appointments which can be booked online? Mine does.

I was wondering whether you could book a telephone appointment for yourself (one when the GP rings to speak to you, rather than someone going into the surgery in person).

I think that it would be helpful to at least tell the GP about your concerns and take advice from him/her.

I'm so sorry for you both, it's really tough. I would think about having the GP visit though, they often have a dietician who can help too. I know you're anxious about your wife's reaction but I would tell her how worried you are about her lack of appetite and how that's obviously going to effect her overall recovery. Hopefully you can get her to try the fortisip drinks.

That combination of medication is quite concerning, OP, and needs discussing with a doctor. She may find meal replacement shakes are easier to manage, especially if they are cold. If she does not like the ones meant for patients like Ensure, you could always try Slimfast or such like - they have a balance of nutrition and taste better than the ones provided by doctors. If you do go down the road of the medical ones, the juice based ones taste a bit better, and you can make them into ice lollies, which also helps.

When I was ill I'd just sip little cups of knorr chicken noodle soup and when I felt up to it would crack a beaten egg in the pan and cook it in for extra nutrition. You can't taste it, it just goes into little ribbons like in chicken and sweetcorn soup from the Chinese. I hope she is feeling better soon.

It's probably the diazepan. Knocks you out and numbs you and that's why it's so addictive. You could get her some Ensure Plus drinks, but they're only around 300 calories so she'll still be undereating. Please take her to the doctor so they can take her off some of those meds. It's not healthy to rapidly lose weight. Has she suffered from an ED in the past and likes how she's getting thinner?

Diazepan should be very, very short term. She is on way too many different kinds of pain meds.

I can really relate to a lot of this as I have been on a similar regime of pain meds & also had a recent admission to hospital (cancer related). I’m normally someone that loves their food but since the hospital admission I have really struggled to eat. I’ve gone off a lot of things I used to enjoy like coffee & builders tea. I suppose the difference between your wife & i is that I am actually worried about losing too much weight as it could affect my cancer treatment. Anyway here are some things that have helped me:
• As others have said not being pressured to eat at meal times & eating little & often. Generally being pressured to eat makes me feel really stressed. My DP has just been getting me whatever I fancy from the shop & sometimes when it arrives I don’t fancy it but I try not to worry. He’s good at not putting any pressure on me to eat but when we stayed with my parents my dad is a feeder & found it really hard!
• I got discharged from hospital with about 40 bottles of fortisip & unfortunately I find that those & Ensure trigger my nausea. The best meal supplement I’ve found is chocolate complan which is a powder you mix with milk. I also drink original coke & fruit juice- apple juice is good for some reason & at least you’re getting some sugar!
• When I can’t face much food I can sometimes tolerate weetabix, natural yoghurt or Greek yoghurt & Heinz tomato soup. I find flavoured yoghurts good actually.

As others have said you sound really caring & supportive. I could really feel your sadness coming through in your latest update. I wonder if it just felt a little too much too soon for your wife? Has she been out at all since the accident? She may just need to build up to these things so try not to be too disheartened. The other thing is that if she doesn’t have much appetite then coffee & cake in the antique shop won’t be as appealing as it would be usually (wonderful as it sounds). I am usually very food motivated & have less motivation to do things when I have no appetite/ feel unwell. Is your wife keeping in touch with friends via message/ phone calls? I am sociable too & this has helped me as like your wife I didn’t feel up to having visitors.

Finally I agree with ringing the GP but at our surgery it’s really hard to get a home visit. I would query follow up support for your wife including a review of her medication & most GP practices have a dietitian that can support if required. It’s nearly 3 months since I came out of hospital & I’m not there yet but my appetite & strength are improving a bit now. As a result I am more keen to go out & do things.

Do keep us updated OP, I know how worried my family & DP have been about me so I understand it’s tough.

It's really hard to eat when you feel nauseous and have no appetite. Is there any special food that she has when she's unwell - like we always have chicken noodle soup and lucozade when we're ill, so I associate these foods with getting better and being taken care of. They're kind of like medicine and not associated to my desire to eat as such, if that makes sense. It's hard to think what to eat when you feel sick.

This is all wonderful advice - thank you so much. A lot to think about here but I’m going to try not to pressure her about it l.
thanks again for all of this

I'm sorry to read your update @Worriedhubby123 , I would be equally worried in your shoes.

Although I stand with the recommendations, I personally think that meal replacement & nourishment drinks are revolting (to the frustration of many doctors & nurses).

Strongly agree that she needs to be seen by the GP but also totally understand your concerns about betraying her trust.

I would let her see the extent of your worry, fear & concern for her. Gentle, persuasive, insistence that you want the GP to visit her to allay your fears and reassure you. Play up that it's because you're so worried rather than because you doubt her word (as it were).
If she still refuses, then I would apologise and say you're sorry, but you're doing it anyway.

This is what I've done in a similar situation, because ultimately, having medical oversight and ensuring she recovers is the priority over watching her waste away. And this isn't a question of mental capacity, if that's what she's scared of, it's because she's not-yet-well and she isn't physically in a position to see what you're seeing, which is that she is wasting away and deteriorating before your eyes.

The alternative is that you speak in confidence with her GP and express your concerns, requesting a home visit. The GP - and yourself, I'm sure - wouldn't be willing to cross the line into deception so if asked would have to be honest that you've prompted the visit. Or just be upfront about it when GP arrives. And you deal with any potential fall out between your wife and yourself.

If it helps, after sharing my worries about a family member's health, I have spoken to their GP about my concerns, on several occasions. I call and explain, first to the receptionist and the the GP, that I'm calling about Family Member, I'm deeply worried. I say that they know I'm calling (I've not yet done it without speaking to them first) and I'm not asking the GP to disclose any confidential information to me. Then I share my concerns, their symptoms ans what i have noticed and observed, that they havent. I then request they make an urgent appointment directly with Family Member.

(Actually I've done this for a friend in crisis too)

I hope this is helpful to you @Worriedhubby123, please let us know how you get on x

Excellent advice from @Soundsofjoy which you might feel is a better approach than my take-the-bull-by-the-horns.

Further to her wonderful advice about food, I'd suggest keeping a little snack plate of finger foods within arms reach. Also would your wife drink milkshakes?

Would she drink Huel @Worriedhubby123?

I think she needs to be sent for neurological assessment. There is a correlation between traumatic brain injury (TBI) often from a car accident and the central nervous system (CNS) becoming hampered such that the patient can no longer feel hunger. Even if she didn’t bang her head, the whiplash means her brain will have moved within her skull at high speed and could have taken a bit of damage. She needs to see a neurologist and get a brain MRI.

Such as this case
”a 20-year-old man, suffered severe TBI in a road accident in May 2006. Neuropsychologic evaluation disclosed impairment in attention, memory and executive function with lack of initiation and awareness. On admission to our center, he had a gastrostomy catheter owing to his refusal to ingest food orally with no particular reason.
The patient exhibited severe apathy, a controlling attitude with obsessive features, rigidity and cognitive inflexibility. Fourteen months after the trauma, the
patient continues without wanting to eat claims lack of appetite and only ingests yoghurts compulsively.

https://www.researchgate.net/publication/46427621_Eating_disorders_in_patients_with_traumatic_brain_injury_A_report_of_four_cases

Just an update for any one interested

She agreed to speak to the doc on the phone on Friday - they have altered her medication and are going to test her for gastroparesis, which the doctor thinks may be the reason for her lack of hunger. Thanks again for all your support

@Worriedhubby123

That's good news, OP, it sounds as though there is some progress.

If she is managing the Fortisips now, she might want to try one of the Nutricrem flavours.

https://harpershealthcare.co.uk/products/nualtra-nutricrem-4x125g-pots-choice-of-flavour

When my dd was having low weight issues (aged late teens/early twenties due to arthritis and not an eating disorder) she had Fortisips and Complan prescribed by her gp. They really helped but she had to be in the mood for them.

I wonder if not only the meds are affecting your wife, but if maybe she has ptsd after the accident. I don't know how bad an accident it was, but to have two compression fractures on her spine sounds awful. Hopefully it'll just be due to the meds, but might be worth gently suggesting counselling to her.

Thanks for your update OP. I was actually going to message as I’ve been thinking of you & your DW. I still have funny days with my appetite & struggle particularly first thing in the morning so this thread has been helpful to me. Do keep us posted if you can, really hoping your DW gets back to her normal self although it will take time I’m sure.

Positive news @Worriedhubby123 keeping fingers crossed for you!